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2025 CPT code 49651

Laparoscopic repair of a recurrent inguinal hernia.

Surgical laparoscopy always includes diagnostic laparoscopy. If a diagnostic laparoscopy is performed as a separate procedure, it is reported using code 49320. For bilateral procedures, append modifier 50.

Modifiers such as 22 (Increased Procedural Services), 50 (Bilateral Procedure), and others may be applicable depending on the specific circumstances of the procedure. Modifier 50 is specifically for a bilateral hernia repair.

Medical necessity for 49651 is established by the presence of a symptomatic, recurrent inguinal hernia. Documentation should support the symptoms, the failure of previous repair(s), and the need for surgical intervention.

The surgeon is responsible for the entire procedure, from prepping and anesthetizing the patient to making the incisions, inserting the laparoscope and instruments, reducing the hernia, placing the mesh, and closing the incisions.

In simple words: The surgeon repairs a hernia in your groin that has returned after a previous surgery. They use a tiny camera and small tools inserted through small cuts, and place a mesh to strengthen the area.

This code describes a procedure where the surgeon uses a laparoscope (a thin tube with a camera) to repair an inguinal hernia that has come back after a previous repair.The procedure is performed through small incisions, and typically involves placing a mesh to reinforce the weakened area in the groin.

Example 1: A 50-year-old male presents with a recurrent right inguinal hernia. He had an open hernia repair 2 years prior. The surgeon performs a laparoscopic repair with mesh placement (49651)., A 65-year-old female presents with a recurrent left inguinal hernia that was previously repaired laparoscopically.The surgeon performs a laparoscopic repair, using mesh reinforcement (49651)., A 45-year-old male has a recurrent bilateral inguinal hernia. He previously underwent a bilateral hernia repair using an open approach. The surgeon now performs a laparoscopic repair on both sides during the same operative session, billing 49651-50.

Documentation should include details about the recurrent nature of the hernia, the location (right, left, or bilateral), the surgical technique used (TAPP or TEP), type of mesh used, and any complications encountered.

** It's crucial to distinguish between initial and recurrent hernia repairs for accurate coding.The choice between laparoscopic and open repair depends on several factors, including the patient's medical history, surgeon's experience, and the characteristics of the hernia.As of December 1st, 2024, this information is current but may be subject to change with updates to CPT coding guidelines.

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