Wiki Laparoscopic Repair Internal Hernia


Anderson, SC
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I have a case of a laparoscopic repair of an internal hernia. The only thing I can find is the unlisted code 49659-unlisted laparoscopy procedure, herniorrhaphy. But payers don't like to pay on this code. So I am asking, is any other code out there? Your thoughts are greatly appreciated. Thanks.
I have to do this quite frequently with bariatric patients that end up getting an internal or Peterson's hernia. I use the unlisted CPT code but write a short note to go with the claim stating that there is no laparoscopic CPT code for this procedure but that the comparable open CPT code is 44050. Also send along the operative note and it usually goes right through with no delay in payment since they have all they need. Hope that helps.
I know this post is old but I'm adding my findings for anyone like me who is currently looking for an answer to this question.
The correct code for Laparoscopic repair of internal hernia is 44238 Unlisted Laparoscopy procedure, intestine.

CPT® Assistant Detail

Article Detail

Year: 2017
Issue: July
Pages: 10
Title: Frequently Asked Questions

Surgery: Digestive System

Question: Is code 49659 the appropriate code to report for a laparoscopic internal hernia repair?

Answer:No, code 49659, Unlisted laparoscopy procedure, herniorrhaphy, herniotomy, is not the correct code to report for a laparoscopic internal hernia repair procedure. The existing open and laparoscopic hernia repair codes, such as code 49659, are used to report the repair of abdominal wall hernias, not internal hernias. By contrast, an “internal” hernia is a herniation into the abdominal cavity. To report a laparoscopic “internal” hernia repair procedure, code 44238, Unlisted laparoscopy procedure, intestine (except rectum), should be reported.