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Wiki Hernia repair 49560-49561

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maryr341

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Coders I have a heated discussion with my Dr. He's coding 49560 for initial ventral hernia repair, reducible, however once he was there he decided is was strangulated so he is also adding code 49561. I told him I can only use the 49561 for the higher level not the 49560. He thinks I'm nuts! I'm starting to believe that....help. I'm doubting myself now because he is so confident that he can bill both. Mind you there was only one hernia.

Please advise....
 
Its a single hernia so it's a single code. It was also a single definitive procedure with a single incision to open. You code for what it is not what you thought it was before making the incision.
 
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