Wiki Need help w/ hernia repair

[mklimm]

I'm a new coder trying to code an open repair of recurrent right inguinal hernia but some of the information in the op note is confusing me. I know it is reducible, recurrent, and open repair but it says it is indirect in nature and he underwent previous surgeries, so is it considered a parastomal hernia? The codes I'm looking at are 49520 or 49621...any thoughts? There was also insertion of mesh stated in the note...I know that is included in 49621 but what about 49520? Should it be coded separate? Indication and findings in the report are below:

INDICATION: This is a male who underwent bilateral laparoscopic inguinal hernia repair five years ago. He states that he had a reducible mass in his right inguinal region 1.5 years ago and was seen in my office where he was diagnosed with recurrent right inguinal hernia and scheduled for an open repair of this recurrent right inguinal hernia.

FINDINGS: Very large right inguinal hernia, indirect in nature, hernia sac very scarred down to the surrounding soft tissue.


-Michelle

 

[csperoni]

I don't see where there is a stoma to consider this a parastomal hernia repair. Provider is documenting reducible recurrent inguinal hernia, as open so 49520. I also don't see anything about mesh. Even if it were documented in the op note, my understanding is it is included in inguinal hernia repair, and no additional coding.