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Capture Orchiopexy and Hernia Repair Pay With This Chart

Published on Fri Mar 06, 2009

Let the surgical approach guide your code choices. As explained in "Mind Your Modifiers When Your Urologist Works With Another Doctor" (page 25), when your urologist performs an inguinal orchiopexy and a hernia repair in the same surgical session using another surgeon as an assistant and not a co-surgeon, you can report both procedures for the urologist. When your urologist performs an inguinal orchiopexy and hernia repair in the same surgical session, you should report 54640 and one of the inguinal hernia repair codes (49495-49525) to ensure that you will be reimbursed for both procedures individually. Don't let the code descriptor for 54640 (Orchiopexy, inguinal approach, with or without hernia repair) confuse you. Bottom line: The Correct Coding Initiative (CCI) and CPT do not bundle 54640 with the inguinal hernia repair codes, says Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology at the State University of New York, [...]
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