Lap Femoral Hernia Repair

AthensCoder

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I have billed a Lap Femoral Hernia repair to Humana (Medicare replacement plan) with CPT 49659 as there is no laproscopic code for a femoral hernia repair. They have denied it stating that unlisted codes are non covered by Medicare. I have gotten feedback on how it should be billed.

Feedback #1: 49550-22 and add 40% to charge amount

Feedback#2: 49550-52

How would you guys bill this. I said #2 because Medicare reimburses less for laproscopic hernia repairs, even though it is more work.

Any comments/opinions would be greatly appreciated.
 
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