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Wiki Reducible vs Incarcerated Hernia

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cayoung

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It would seem that determining whether to use a reducible vs an incarcerated CPT code would be simple enough. Here goes...A physician is noting that an incarcerated hernia was repaired. Within the dictation, the incarcerated fat is reduced and a patch applied. So, is this incarcerated or reducible? Can incarcerated hernia only contain "fat"? Or must it contain bowel, too? (I'm looking at CPT codes 49655 vs 49654.)
 
It's my understanding that an incarcerated hernia is a hernia which cannot be externally manually reduced. An incarcerated hernia may contain fat, omentum, or bowel. This hernia was surgically reduced intra-operatively which is part of the repair -- the surgeon is not going to repair a hernia without reducing the incarceration. This procedure should be coded as an incarcerated hernia repair.

Julie, CPC
 
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