2025 CPT code 49520
(Active) Effective Date: N/A Repair Procedures on the Abdomen, Peritoneum, and Omentum - Hernioplasty, Herniorrhaphy, Herniotomy Procedures Surgery Feed
Repair recurrent inguinal hernia, any age; reducible.
Modifiers such as 22 (Increased Procedural Services) and 50 (Bilateral Procedure) may be applicable depending on the circumstances of the procedure.
Medical necessity for 49520 is established by the presence of a symptomatic, recurrent, reducible inguinal hernia that impacts the patient's quality of life or presents a risk of complications like incarceration or strangulation.
The surgeon is responsible for the entire procedure, from prepping and anesthetizing the patient to making the incision, reducing the hernia, closing the incision, and post-operative care instructions.
- Surgery
- Surgical Procedures on the Digestive System; Surgical Procedures on the Abdomen, Peritoneum, and Omentum; Repair Procedures on the Abdomen, Peritoneum, and Omentum; Hernioplasty, Herniorrhaphy, Herniotomy Procedures; Hernia Open Procedures
In simple words: This procedure fixes a hernia in the groin area (called an inguinal hernia) that has come back after a previous repair.The hernia can be pushed back into place, and the surgery reinforces the area to prevent it from happening again.
This procedure addresses a recurrent inguinal hernia that is reducible, irrespective of the patient's age.The surgeon makes an incision over the previous surgical scar, dissects through the scar tissue to locate the hernia sac, and reduces the hernia by manually manipulating the protruding contents back into the abdominal cavity.The hernia sac may be dissected from surrounding tissues.Finally, the incision is closed.
Example 1: A 60-year-old male presents with a recurrent reducible inguinal hernia, previously repaired 5 years ago. He undergoes open surgical repair using code 49520., A 2-year-old child with a history of a repaired inguinal hernia now has a recurrent reducible hernia. The surgeon performs an open repair (49520)., A 45-year-old female presents with a recurrent, easily reducible inguinal hernia, initially repaired during her childhood. Code 49520 is used for the open surgical repair.
Documentation should include details about the recurrent nature of the hernia, confirmation of its reducibility, operative report detailing the surgical technique, and any complications encountered.
- Revenue Code: P5C - AMBULATORY PROCEDURES - INGUINAL HERNIA REPAIR
- Payment Status: Active
- Specialties:General Surgery, Pediatric Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center