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Recurrent inguinal hernia laparoscopic repair

bertll

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I have coded 49651, but in addition the surgeon dictates the following.
"We then turned out attention to the left groin and made a small incision over the pubic tubercle there where we could feel a palpable nodularity. We dissected down to the mesh itself and then carefully, meticulously dissected it free from cord and associated structures, as it had definitely migrated out of the canal altogether. Once this was removed and we were satisfied with our hemostasis, we then closed this level of skin with a 4-0 Monocryl. Fascia of our infraumbilical incision was closed with a running 0 Vicryl, and the skin of all incisions was closed with 4-0 Monocryl in subcuticular fashion. Skin glue was used to reinforce this."

Do I add modifier 22 or code 49999? Any help would be appreciated.
 
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