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Tip: Know the new laparoscopic hernia repair procedures

Ambulatory Surgery Reimbursement Update, December 2, 2008

The AMA added six new CPT codes for 2009 for the laparoscopic repair of ventral, umbilical, epigastric (i.e., hiatal hernia), and incisional hernias. (ASCs previously only had laparoscopic CPT codes for inguinal hernia repairs.)

Medicare added these six new codes to its list of covered procedures, effective January 1, 2009. Medicare reimburses for the new codes at $1,529.28 nationally.

The new codes are as follows:

  • Code 49652—Laparoscopy, surgical; repair, ventral, umbilical, spigelian or epigastric hernia; reducible, which includes the mesh insertion, when performed
  • Code 49653—Laparoscopy, surgical; repair, ventral, umbilical, spigelian or epigastric hernia; incarcerated or strangulated, which includes the mesh insertion, when performed
  • Code 49654—Laparoscopy, surgical; repair, incisional hernia; reducible, which includes the mesh insertion, when performed
  • Code 49655—Laparoscopy, surgical; repair, incisional hernia; incarcerated or strangulated, which includes the mesh insertion, when performed
  • Code 49656—Laparoscopy, surgical; repair, recurrent incisional hernia; reducible, which includes the mesh insertion, when performed
  • Code 49657—Laparoscopy, surgical; repair, recurrent incisional hernia; incarcerated or strangulated, which includes the mesh insertion, when performed

This tip is brought to you by Ellis Medical Consulting, Inc.

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