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Code for repair of bladder hernia?

  1. #1
    Location
    Hamden, CT
    Posts
    23
    Default Code for repair of bladder hernia?
    Medical Coding Books
    Hi everyone!
    Can someone please help me to find a CPT code for repair of a bladder hernia? I have never seen this before. I tried to find a clue on many sites as well as googled it, and it keeps sending me to 49560??

    Any input is appreciated. I need this fairly quickly as we need to precert this. Thanks so much for any help.

    renee
    Renee R. Antonetti

  2. Default Hernias catagorized by type...inguinal, femoral ...
    The code is correct for a ventral hernia; if further information (the op report) indicates an incarcerated or strangulated hernia then 49561 is the appropriate code. Also, is it a recurrent hernia? Then use the codes with that description.

    See you cpt book for complete description.

  3. #3
    Location
    Hamden, CT
    Posts
    23
    Default
    thanks for your reply, when reading on this condition it says usually is missed because it involves the inguinal, femoral and/or scrotal area.

    but use this code for BLADDER hernia?? We are trying to get clarification from the doctor on whether it involves the inguinal, femoral area.
    Renee R. Antonetti

  4. #4
    Default
    Looks like you are going to have to use 49659 for this one. I would include a letter to the payor explaining this and suggesting a comparable code, it might avoid a future appeal.


    Good luck!
    ***********

    PB

  5. Default
    Quote Originally Posted by renee868 View Post
    thanks for your reply, when reading on this condition it says usually is missed because it involves the inguinal, femoral and/or scrotal area.

    but use this code for BLADDER hernia?? We are trying to get clarification from the doctor on whether it involves the inguinal, femoral area.
    The code is correct as described. The bladder is protruding through some other anatomy. The codes are divided by the type of hernia, not necessarily by the anatomic site.

    I don't agree with the unlisted procedure code. This isn't novel surgery.

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