2025 CPT code 49618
(Active) Effective Date: N/A Surgery - Digestive System Surgery Feed
Repair of one or more recurrent anterior abdominal hernias, incarcerated or strangulated, with a total defect length greater than 10 cm, using any approach.
Modifiers may be applicable to 49618 to indicate specific circumstances of the procedure, such as increased procedural services (modifier 22) or multiple procedures (modifier 51 if applicable and not bundled by payer policies).
Medical necessity for 49618 is established by the presence of a symptomatic, recurrent, incarcerated or strangulated anterior abdominal hernia requiring surgical repair.The documentation should support the clinical findings necessitating the procedure.
The surgeon prepares the patient and performs the hernia repair using an open, laparoscopic, or robotic approach.They identify the hernia sac, which is either incarcerated or strangulated, and return the trapped tissue to its proper position.The surgeon may use sutures, mesh, or another prosthesis to reinforce the weakened abdominal wall.The total length of all repaired defects, measured before opening, exceeds 10 cm.
In simple words: The surgeon repairs a hernia in the front of your abdomen that has come back after a previous surgery. The hernia is trapped or the blood supply to the trapped tissue is cut off.The surgeon can use any surgical method. The total size of the area being repaired is larger than 10 centimeters. A mesh or other support material might be used in the repair.
Repair of anterior abdominal hernia(s) (i.e., epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated.
Example 1: A patient presents with a recurrent incarcerated umbilical hernia larger than 10 cm, which is repaired laparoscopically with mesh implantation., A patient with a history of incisional hernia repair presents with a recurrent strangulated ventral hernia exceeding 10 cm, requiring open surgical repair with mesh., A patient has a recurrent spigelian hernia, greater than 10 cm, that is incarcerated. The surgeon performs a robotic-assisted repair with mesh implantation.
Documentation should include the type of hernia (e.g., umbilical, incisional, ventral, epigastric, spigelian), the status (incarcerated or strangulated), the approach used (open, laparoscopic, robotic), the size of the defect(s) before opening (greater than 10 cm), and whether mesh or other prosthesis was used. Previous hernia repair(s) should also be documented to confirm recurrence.
** When measuring the hernia defect, use the greatest dimension (either transverse or craniocaudal) before opening. If multiple defects are repaired, sum the individual defect lengths. Ensure documentation clearly specifies the total defect length and the incarcerated/strangulated status of the hernia(s).For information on add-on codes for mesh removal, see CPT guidelines.
- Specialties:General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center