Results 1 to 2 of 2

Thread: Help w/ Hernia

  1. #1
    Join Date
    Apr 2007
    Location
    Bangor, Maine
    Posts
    719

    Default Help w/ Hernia

    Promo: Code Books
    I have a direct bilateral inguinal hernia repair, but one side was resected because of the size of the sac, rather than reduced. The other side was simply reduced. Do I just code the repair code with the bilateral modifier or do I code the resect sac seperately?

    =One the right, a rather unusual long direct hernia sac was present and measured approx 8cm in length, through which the the small intestine was herniating. Due to the size of the sac and the tendancy for intestinal herniation, I elected to resect the sac instead of just reducing it under the mesh. The external oblique was opened into the external ring, and the spermatic cord was retracted with a penrose drain. The direct hernia was dissected free and again was a very large, long sac. I was uncomfortable with just ligating this, and I opened it and reduced it the small intestine and then put a Purstring suture under direct position, ensuring that the intestine was not included in the suturing. This sac was then resected. The stump of the sac was then reduced with a figure 8 suture. The cremaster muscle fibers were opened and the peritoneal reflection was identified to confirm that no ecteric sac was present. The floor of the canal was then reconstructed using mesh, securing the mesh inferiorly to the inguinal ligament, medial to the rectus sheath, supieriorly to the conjoint tendon and laterally.
    Any help or additional info would be great!

  2. #2
    Join Date
    Apr 2007
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338

    Default

    Quote Originally Posted by LeslieTibbetts View Post
    I have a direct bilateral inguinal hernia repair, but one side was resected because of the size of the sac, rather than reduced. The other side was simply reduced. Do I just code the repair code with the bilateral modifier or do I code the resect sac seperately?

    =One the right, a rather unusual long direct hernia sac was present and measured approx 8cm in length, through which the the small intestine was herniating. Due to the size of the sac and the tendancy for intestinal herniation, I elected to resect the sac instead of just reducing it under the mesh. The external oblique was opened into the external ring, and the spermatic cord was retracted with a penrose drain. The direct hernia was dissected free and again was a very large, long sac. I was uncomfortable with just ligating this, and I opened it and reduced it the small intestine and then put a Purstring suture under direct position, ensuring that the intestine was not included in the suturing. This sac was then resected. The stump of the sac was then reduced with a figure 8 suture. The cremaster muscle fibers were opened and the peritoneal reflection was identified to confirm that no ecteric sac was present. The floor of the canal was then reconstructed using mesh, securing the mesh inferiorly to the inguinal ligament, medial to the rectus sheath, supieriorly to the conjoint tendon and laterally.
    Any help or additional info would be great!
    Hi Leslie,
    Since the 49505 includes resection of the hernia sac (see lay description) you would code the 49505-50 (assuming this is an open procedure and not lap)

Similar Threads

  1. Bilateral lap inguinal hernia and open hernia repair
    By tlivengo in forum General Surgery
    Replies: 1
    Last Post: 04-23-2014, 10:58 AM
  2. Replies: 3
    Last Post: 05-10-2012, 08:08 AM
  3. Replies: 0
    Last Post: 03-21-2012, 11:12 AM
  4. Ventral hernia, incidental umbilical hernia, can bill for mesh?
    By trinalankford in forum General Surgery
    Replies: 4
    Last Post: 03-01-2011, 11:40 AM
  5. lap Inguinal hernia w/ open umbilical hernia repair
    By ihaghighat in forum General Surgery
    Replies: 4
    Last Post: 09-30-2009, 06:55 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.