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Hernia codes driving me INSANE! Help please

  1. Default Hernia codes driving me INSANE! Help please
    Medical Coding Books
    Please help, there are so many code and terms I'm sooo confused. Was thinking 49507 but don't see anything in that code regarding Mesh...???

    REOP DIAG: Incarcerated left inguinal hernia
    PROCEDURE PERFORMED: left inderect inguinal hernia repair with mesh

    Abdomen prepped and draped in a sterile fashion. 6cm incision from the line connecting the pubic tubercle to the anterior superior illac spine using a #15 blade. The deeper tissue were dissected using the cautery current with bovie. The fascia incised using the cutting current of the bovie and then extended the incision medially and then laterally.

    The fascia was grasped between 2 allis clamps and the hernia sac was easily seen as well as the ilioinguinal nerve which was dissected and removed and retracted out of the field. The sac opened and contents omentum which was reducted into abdominal cavity. The sac was then dissected free from the vas deferens and the blood supply. The testicle was brought out of the scrotum and the sac was completely dissected and the testicles returned back to the scrotum The sac was then ligated at its base and the sac was transected above the suture and sent off the field to path. The would was irrigated and dried. There was a small component of direct hernia persent as well and decision was made to use performed mesh with a small diaphragm that sits in the direct space. the apex of the mesh was sutured down to the pubic tubercle using a 2-0 prolene and interrupted stitches were used to suture the mest with a 2-0 prolene to the conjoined tendons superiorly and inferiorly to th einguinal ligament.

    A small incision made in the mesh to wrap around the cord structures ensuring that the vas was protected. Continued to insure cord would not be strangulated. Fascia was closed over the repair using vicryl running stitch. This tied medially. Wound irrigated and dried. Scarpa's fascia was closed with vicryl in an interrupted fashion. Skin closed with 4.0 subcuticulars. irrigated and dried.

  2. #2
    Codes 49495-49557 include initial repair: no previous repair required; mesh or other prosthesis; recurrent repair: required previous repair so you won't need to look for the mesh. Other than that, I'm in the same boat as you so I can't help you I'm trying to learn them and I have also posted questions too lol!

    Brooke Bierman, CPC, CPB
    Coding & Billing Manager
    2014 President AAPC Des Moines Chapter

  3. Default
    49507 is for an initial incarcerated hernia, over 5 years old. Mesh is not separately reported for any hernias except for open ventral/incisional hernias. You can only charge for mesh using codes 49560-49566.

  4. Default 15777 for inguinal hernias?
    How about Cpt 15777? Can that be used for the mesh for inguinal hernia repairs? The descriptor really doesn't say you can't bill for the mesh for hernia repairs other than incisional and ventral.

  5. #5
    49507- this is what i have always coded

  6. Default
    Since 15777 is new for 2012, I just figured that maybe it's billable.

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