Laparoscopic Recurrent Inguinal Hernia Repair Cpt

For inguinal hernia repair cpt code 49505 the surgeon may use an ilioinguinal or iliohypogastric nerve block cpt 64425. Codes in the abdominal repair section of cpt 49491 49659 are categorized primarily by the type of hernia being repaired location and the approach open vs laparoscopic. Laparoscopic epigastric and hiatal hernia repair is.

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Mesh is always a part of laparoscopic repair.

Laparoscopic recurrent inguinal hernia repair cpt. Between two and four small incisions are made through the abdominal wall through which are passed the laparoscope a thin telescope with a light on the end and surgical instruments into the abdomen. Laparoscopic inguinal hernia repair keyhole surgery laparoscopic inguinal hernia repair uses an instrument called a laparoscope. The largest of these was a danish study of hernia registry patients with recurrence after lichtenstein repair the operative re recurrence rate was 11 3 when a second lichtenstein repair was performed but only 1 3 when a laparoscopic repair was performed. This study aimed to evaluate the effects of laparoscopic and open mesh repair in the treatment of recurrent inguinal hernia by conducting a meta analysis of randomized controlled trials rcts.

However the effects of laparoscopic and open mesh repair in the treatment of recurrent inguinal hernia are unclear. In 1994 when codes 49650 and 49651 were created very few laparoscopic inguinal hernia repairs were performed for incarcerated hernias. In this case the nerve block is not reported separately and is included in the surgical procedure. 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.

The 1994 cpt code set added only two codes for laparoscopic hernia repair 49650 and 49651. Do not report 49568 with laparoscopic ventral incisional hernia repair. If recurrent hernia repair is done with removal of implanted mesh from a previous surgery removal of mesh is included in the recurrent hernial repair and should not be coded separately. Laparoscopic hernia repair was developed as a technique long after open hernia repair.

Some are further defined as initial or recurrent depending on whether or not the hernia has required prior surgical repair. Laparoscopic inguinal herniorrhaphy has gained wide popularity with many surgeons and patients. So 64425 is bundled into 49505. 1 2 despite the high satisfaction rate risks are inherent to laparoscopic herniorrhaphy just as with standard open repairs.

Laparoscopic surgical hernia repair. Inguinal hernia repair is a common surgical procedure. Repair recurrent incisional or ventral hernia. Early resumption of normal activities and less postoperative pain are two of its main benefits.

Outcomes for repair of recurrent inguinal hernia have been evaluated in several large scale studies. Nerve entrapments hematomas and recurrences are all well known. Reducible 49565 5361 j1 4 596 incarcerated or strangulated 49566 5361 j1 4 596 implantation of mesh or other prosthesis for open incisional or ventral hernia 49568 n.