Highlights
Providing free resources and useful informations for Physicians,
Office Managers, Medical Billers and Medical Coders
Medical Billing
Codes
Procedural
Codes for
Hernia Repair
for
Open or
Laparoscopic
Method
from
MY BLOG
Here are the medical billing codes that you can review for HERNIA Repair. Find what medical billing codes fits your need. I am hoping this information can help and save you time finding your medical billing codes for hernia repair. I have also embedded some videos on these procedures so you can have a better understanding on how this procedure is performed by your surgeon.

General Surgery Coding - How to Bill for Hernia Repairs

What to Look for when coding for Hernia.

1. Anatomical location of the hernia (epigastric, hiatal, inguinal, incisional, femoral, ventral, etc.) 2. Age of the Patient (younger than 5 years old? older than 5 years old?) 3. What Surgical Method was used - is it Laparoscopic or Open Procedure? 3. Is the Hernia recurrent? or not? 4. Is the Hernia incarcerated or strangulated? 5. Was a placement of mesh being utilized? Pointers: 1. I will recommend to use the proper location/site modifier whenever it is applicable (eg. 50 for Bilateral, LT for Left Side and RT for Right Side) 2. Mesh placement is only billable for Ventral and Incisional Hernia 3. These CPT procedures has 90 days global period 4. Placement of Mesh CPT Code 49568 can only be billed together with Incisional and Ventral Hernia repair per Medicare's NCCI Edits Manual. 5. Billable with an Assistant Surgeon (refer to your modifier for assist)  

OPEN Surgical Hernia Repair - General Surgery Codes

 

Laparoscopic Surgical Hernia Repair - General Surgery Codes

Laparoscopic Surgical Hernia Repair - General Surgery Codes

CPT Codes for Laparoscopic Epigastric Hernia Repair

49652 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible 49653 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); incarcerated or strangulated

CPT Codes for Laparoscopic Hiatal Hernia Repair

43281 Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh 43282 Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh

So you can have a better understanding about this procedure. Watch this video on Laparoscopic Hiatal Hernia Repair

 

CPT Codes for Laparoscopic Incisional Hernia Repair

49654 Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); reducible 49655 Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated 49656 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); reducible 49657 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated  

CPT Codes for Laparoscopic Inguinal Hernia Repair

49650 Laparoscopy, surgical; repair initial inguinal hernia 49651 Laparoscopy, surgical; repair recurrent inguinal hernia

So you can have a better understanding about this procedure. Watch this video on Laparoscopic Inguinal  Hernia Repair

 

CPT Codes for Laparoscopic Spigelian Hernia Repair

49652 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible 49653 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); incarcerated or strangulated

CPT Codes for Laparoscopic Umbilical Hernia Repair

49652 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible 49653 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); incarcerated or strangulated

CPT Codes for Laparoscopic Ventral Hernia Repair

49652 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible 49653 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); incarcerated or strangulated

OPEN Surgical Hernia Repair - General Surgery Codes

CPT Codes for Epigastric Hernia Repair

49570 Repair epigastric hernia (eg, preperitoneal fat); reducible (separate procedure) 49572 Repair epigastric hernia (eg, preperitoneal fat); incarcerated or strangulated

CPT Codes for Femoral Hernia Repair

49550 Repair initial femoral hernia, any age; reducible 49553 Repair initial femoral hernia, any age; incarcerated or strangulated 49555 Repair recurrent femoral hernia; reducible 49557 Repair recurrent femoral hernia; incarcerated or strangulated

CPT Codes for Hiatal Hernia Repair

43332 Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis 43333 Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis 43334 Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis 43335 Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis 43336 Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; without implantation of mesh or other prosthesis 43337 Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis

CPT Codes for Incisional Hernia Repair

49560 Repair initial incisional or ventral hernia; reducible 49561 Repair initial incisional or ventral hernia; incarcerated or strangulated 49565 Repair recurrent incisional or ventral hernia; reducible 49566 Repair recurrent incisional or ventral hernia; incarcerated or strangulated

CPT Codes for Inguinal Hernia Repair

49495 Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; reducible 49496 Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; incarcerated or strangulated 49500 Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible 49501 Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated 49505 Repair initial inguinal hernia, age 5 years or older; reducible 49507 Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated 49520 Repair recurrent inguinal hernia, any age; reducible 49521 Repair recurrent inguinal hernia, any age; incarcerated or strangulated 49525 Repair inguinal hernia, sliding, any age  

General Surgery Coding - Video Inguinal Hernia Open Repair Procedure (for your better understanding!)

 

 CPT Codes for Lumbar Hernia Repair

49540 Repair lumbar hernia

CPT Codes for Spigelian Hernia Repair

49590 Repair spigelian hernia

CPT Codes for Umbilical Hernia Repair

49580 Repair umbilical hernia, younger than age 5 years; reducible 49582 Repair umbilical hernia, younger than age 5 years; incarcerated or strangulated 49585 Repair umbilical hernia, age 5 years or older; reducible 49587 Repair umbilical hernia, age 5 years or older; incarcerated or strangulated