I also bill for these and was a little confused as well. But if you look at ICD-9codes for ventral hernia, the code used for recurrent ventral hernia falls under 553.21 incisional hernia...while spigelian & epigastric fall under 553.29 other ventral hernia.
So I would understand that to mean recurrent ventral hernias should be billed as 49656, lap repair of recurrent incisional hernia.
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