Therefore we cannot report cpt 49568 for insertion of mesh like we could in the first example. Laparoscopy this method leaves smaller scars than.
For all other hernia repairs such as epigastric umbilical etc open or laparoscopic add on code 49568 cannot be billed for placing the mesh during the repair by the provider.
Repair of inguinal hernia with mesh cpt code. Cpt lists only three codes for laparoscopic hernia repair including two codes for inguinal hernia repair 49650 any initial repair and 49561 all recurrent repairs and a single unlisted procedure code 49659 to cover laparoscopic repairs of all other hernia types regardless of patient age or initial recurrent reducible strangulated status. Note that a code using root operation u supplement stands by itself as a hernia repair procedure and no additional code is required or assigned to capture the repair or use of mesh. Repair initial inguinal hernia preterm infant younger than 37 weeks gestation at birth performed from birth up to 50 weeks postconception age with or without hydrocelectomy.
Login to read the rest of. Placement of mesh can only be billed together with incisional and ventral hernia repair per medicare s ncci edits manual. In fact despite recent negative press regarding use of abdominal mesh use of mesh in an inguinal hernia repair remains the standard of care.
Cpt code 49659 unlisted laparoscopy procedure hernioplasty herniorrhaphy herniotomy is reported when a cpt code does not exist for the type of repair performed. The open hernia repair codes are found in the range of codes 49491 49611. In this case the nerve block is not reported separately and is included in the surgical procedure.
For inguinal hernia repair cpt code 49505 the surgeon may use an ilioinguinal or iliohypogastric nerve block cpt 64425. Laparoscopic surgical hernia repair. The laparoscopic codes are found in the cpt range of codes 49650 49657.
While the surgeon placed mesh to repair the hernia the cpt guidelines state that with the exception of open incisional or ventral hernia repairs 49560 49566 the insertion of mesh or other prosthesis is not separately reportable. Body part on their given code tables specific body part values are available for diaphragm abdominal wall inguinal region femoral region and other lower. So 64425 is bundled into 49505.
Add on code 49568 implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection list separately in addition to code for the incisional or ventral hernia repair can be used only with incisional or ventral hernia repairs 49560 49566.