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2025 CPT code 49622

Repair of a parastomal hernia, using any approach (open, laparoscopic, or robotic), for incarcerated or strangulated hernias, including mesh or prosthesis implantation if performed.

Follow CPT guidelines for hernia repair, paying close attention to the distinction between reducible and incarcerated/strangulated hernias.Accurate documentation is crucial for proper code selection.

Modifiers may be applicable based on the circumstances of the procedure (e.g., modifier 50 for bilateral procedures, if applicable; other modifiers as per the NCCI guidelines).

Medical necessity for repair is established by the presence of symptoms such as pain, bowel obstruction, or risk of strangulation.Documentation should support the clinical indication for surgery and the chosen surgical technique.

The surgeon is responsible for pre-operative assessment, surgical planning, hernia reduction, defect repair (including mesh placement if needed), hemostasis, and wound closure. Anesthesiologist may be involved for anesthesia administration.

IMPORTANT:Code 49621 is used for reducible parastomal hernias.Code +49623 is an add-on code for removal of mesh or prosthesis during the same procedure.Other hernia repair codes (e.g., inguinal, femoral) may be used concurrently for repairs in other locations during the same operative session.

In simple words: This code covers surgery to fix a hernia near an opening in the body (stoma) for waste disposal. The hernia is trapped and may have restricted blood flow. The surgeon will fix it using the best approach (open, laparoscopic, or robotic) and might use a mesh to support the repair.

This CPT code encompasses the surgical repair of an incarcerated or strangulated parastomal hernia, which is a hernia occurring near a stoma (surgical opening). The repair can be performed via an open, laparoscopic, or robotic approach.The procedure includes the reduction of the hernia, repair of the defect, and implantation of mesh or other prosthesis if deemed necessary. The code applies to both initial and recurrent parastomal hernias.

Example 1: A 65-year-old patient with a history of colostomy presents with an incarcerated parastomal hernia.The surgeon performs an open repair with mesh placement., A 40-year-old patient with a newly created ileostomy develops a strangulated parastomal hernia. The surgeon performs a laparoscopic repair without mesh., A 70-year-old patient with a recurrent parastomal hernia following previous open repair presents with an incarcerated hernia.A robotic-assisted repair with mesh placement is performed.

Pre-operative diagnosis (including hernia location, size, and reducibility), operative report detailing the approach (open, laparoscopic, or robotic), hernia characteristics (incarcerated/strangulated), technique used, mesh or prosthesis use, post-operative findings, and any complications.

** Mesh or other prosthesis implantation, when performed, is included in the code.For removal of mesh, see code +49623 (add-on code).

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