This is what 3M tells me:
Initial treatment of a hernia may be performed by manual reduction. This reduction is performed as part of an evaluation and management (E/M) service and is not reported separately.
When manual reduction is the only service performed, unlisted code 49999 may be reported.
So, since your physician will also (I assume) be charging an ER visit, then the manual reduction is inclusive to the E/M.
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