49561 becuase it is an incarcerated hernia ( 'incanceration' in hernia refers in terms of the internal tissues or organs getting jammed up in to the defective facia or ring an dbecomes irreducible).
49568 as per the CPT guidelines, the incisional/ventral hernias when performed with the mesh for closure should be listed separately in addition to the code fpr the primary procedure. Partial omentectomy is a component of the incarcerated hernia repair
Hope this helps. but when it comes to organ system excision, appropriate excision code might be used in addtion to the appr code for repair of the strangulated hernia.
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