Wiki NEED HELP 1.LAPAROSC REDUCTION INCARCERATED INCISIONAL HERNIA. 2.INCISIONAL HERNIA REPAIR WITH 4X9 INCH INLAY WHAT CODE SHOULD I USE

[alisakaraminasyan@yahoo.com]

Procedures Performed: 1. Laparoscopic reduction of incarecerated incisional hernia. 2. Incisional hernia repair with 4x9 inch Inlay Ventral ite ST oval mesh do i need to bill with two cpt code or one for both procedures? what code should i use 49591/49560?

 

[xXxPARAGONxXx]

Procedures Performed: 1. Laparoscopic reduction of incarecerated incisional hernia. 2. Incisional hernia repair with 4x9 inch Inlay Ventral ite ST oval mesh do i need to bill with two cpt code or one for both procedures? what code should i use 49591/49560?

Either CPT code 49592, 49594, or 49596, the key being that the hernia was incarcerated.

The header of these codes is:

Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s);

The next aspect that you have to specify is the total length of the hernia defect measured prior to opening the hernia defect, which is measured as the maximal craniocaudal or transverse distance between the outer margins of the defect repaired. You mention a 4" x 9" mesh, but mesh size does not correspond to the size of the hernia defect measured prior to opening the hernia defect. Rather, “[f]or repair of umbilical, ventral and incisional hernia, [mesh] should be at least 4 cm wider than the defect”.[1]

You will need to determine that measurement, and then you can select the appropriate code from 49592, 49594, or 49596. If you are unable to determine that measurement from the operation report, then you must default to the code specifying the smallest measurement (i.e., 49592).