2025 CPT code 49507
(Active) Effective Date: N/A Surgery - Hernia Open Procedures Surgery Feed
Repair initial inguinal hernia for patients 5 years or older; incarcerated or strangulated.
Modifiers may be applicable. Modifier 50 is used for bilateral procedures. Other modifiers like 22 (increased procedural services), 52 (reduced services), or 78 (return to the operating room) can be appended if applicable based on specific circumstances.
Medical necessity for 49507 is established by the presence of an incarcerated or strangulated inguinal hernia causing symptoms such as pain, discomfort, nausea, vomiting, or inability to reduce the hernia. The documentation should clearly support the need for surgical intervention to alleviate the symptoms and prevent complications such as bowel obstruction or ischemia.
The surgeon is responsible for the complete surgical repair of the hernia, including prepping the patient, administering anesthesia, making the incision, dissecting the tissue, reducing the hernia, potentially resecting any damaged intestine (reported separately), placing mesh reinforcement, closing the incision, and managing post-operative care.
In simple words: This procedure fixes a hernia in the groin where the intestines are pushing through a weak spot in the muscle. It's used when the hernia is trapped or its blood supply is cut off, and it's for patients 5 years and older who haven't had this type of hernia repair before. The surgeon makes a cut in the groin, puts the intestines back in place, and fixes the muscle wall, often using a mesh to strengthen the area.
This procedure describes the surgical repair of an initial incarcerated or strangulated inguinal hernia in patients 5 years of age or older.An inguinal hernia occurs when part of the intestine protrudes through a weak point in the abdominal wall in the groin area.Incarcerated means the hernia is trapped and cannot be pushed back into place, while strangulated means the blood supply to the herniated tissue is cut off, which is a medical emergency. The procedure involves making an incision in the groin, dissecting the tissue to access the hernia, releasing the trapped tissue, and repairing the abdominal wall defect, often with mesh reinforcement.
Example 1: A 7-year-old child presents with an incarcerated inguinal hernia causing significant pain and discomfort. The hernia cannot be manually reduced, and the decision is made to perform surgical repair using code 49507., A 60-year-old man with a history of inguinal hernias develops a strangulated hernia with signs of compromised blood flow to the herniated bowel. Emergency surgery is performed using code 49507 to address the strangulation and repair the hernia., A 10-year-old girl presents with a recurrent incarcerated inguinal hernia.Since this is a recurrent hernia, code 49507 would not be used. Instead, code 49521 would be used.
Documentation should include details of the patient's history, physical exam findings confirming the incarcerated or strangulated inguinal hernia, type and size of the hernia, operative report detailing the surgical technique, type of mesh used (if any), any complications encountered, and post-operative instructions.
** The inclusion or exclusion of mesh placement does not influence code selection for inguinal hernia repair, as mesh is considered an inherent component of modern hernia repair techniques.
- Revenue Code: P1G - Major Procedure - Other
- Payment Status: Active
- Specialties:General Surgery, Pediatric Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center