If the surgeon performs a laparoscopic release and repair of an
incarcerated internal hernia of the small intestine, should I bill an
unlisted code such as 49659?
You should use an unlisted code, but the better choice is 44238 (Unlisted laparoscopy procedure, intestine [except rectum]) instead of 49659 (Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy).
That's because the lap hernia codes (49650- 49659) describe laparoscopic repair of hernias in the abdominal wall. The situation you describe involves an internal hernia in the small intestine, and CPT does not provide a specific code for that service.
Option:If your surgeon performed an open release and repair of an incarcerated internal hernia of the small intestine, you would still use a code that involved the "intestines." Your choice for an open procedure would be 44050 (Reduction of volvulus, intussusception, internal hernia, by laparotomy).
You should use an unlisted code, but the better choice is 44238 (Unlisted laparoscopy procedure, intestine [except rectum]) instead of 49659 (Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy).
That's because the lap hernia codes (49650- 49659) describe laparoscopic repair of hernias in the abdominal wall. The situation you describe involves an internal hernia in the small intestine, and CPT does not provide a specific code for that service.
Option:If your surgeon performed an open release and repair of an incarcerated internal hernia of the small intestine, you would still use a code that involved the "intestines." Your choice for an open procedure would be 44050 (Reduction of volvulus, intussusception, internal hernia, by laparotomy).
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