Hernias - Freestanding ASC


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Good afternoon -

I got some information telling us that the new CPT Hernia codes 49591-49623 cannot be done in our Surgery center, getting kick back from our UM dept that they must be done in a hospital outpatient ASC.

New codes incorporate any approach, so I am little confused as to why they cannot be done in our surgery center. Is this true or not? trying to locate information.

I can't find anywhere to let me know that they cannot be done in our surgery center. Why would we need to send a patient to a hospital outpatient facility, if there is no need to.

that would be loss revenue to our organization and providers when we can do procedures in house.

Any information would be greatly appreciated it.
CPT codes 49591-49595 and 49613-49615, as well as lap inguinal codes 49650-49651, are all listed with indicator G2 on the CMS 2023 ASC Addenda, so I don't know why your organization would be telling you that these can't be done in the ASC. I think you'd just need to ask them what their source of this information is. Perhaps they were looking at the 2022 Addenda before the new one came out?