How To Use CPT Code 49650

CPT 49650 refers to the laparoscopic repair of an initial inguinal hernia which occurs when a piece of intestine or other structure within the abdomen bulges through the muscles of the inguinal canal. With the use of laparoscopic techniques, the surgeon can repair the hernia causing minimal discomfort and recovery time to the patient.

The official description for CPT code 49650 is: “Laparoscopy, surgical; repair initial inguinal hernia.”

Short description: Laparoscopic repair of an initial inguinal hernia.

Procedure for CPT code 49650

The patient is prepared and given anesthesia. A small incision is created in the abdominal wall and the abdomen is filled with carbon dioxide to provide a better view of the internal organs. Further incisions are made to accommodate the laparoscopic camera and surgical instruments. The surgeon then guides the herniated tissue back into the abdomen and may place a mesh over the opening in the abdominal wall to reinforce it and prevent the hernia from recurring. Once the surgeon is satisfied with the repair, the laparoscopic port is removed and the incisions are closed using absorbable sutures.

Qualifying circumstances CPT Code 49650

CPT code 49650 applies to patients diagnosed with an initial inguinal hernia that warrants surgical repair. Patients suitable for this procedure are those whose hernias involve the contents of the abdomen protruding directly through the wall of the inguinal canal, and who are generally healthy enough to withstand a laparoscopic surgical procedure.

When to use CPT Code 49650

CPT 49650 is used when a healthcare provider performs laparoscopic surgical repair of an initial inguinal hernia. This code should be used explicitly for the first hernia repair, but not for subsequent repairs or different types of hernias.

Documentation requirements

Appropriate documentation for CPT 49650 includes a definite diagnosis of an initial inguinal hernia, the patient’s eligibility for the procedure, a detailed account of the surgical procedure performed, the use of mesh(if applicable), postoperative care instructions, and any complications that occurred during the procedure.

Billing guidelines CPT Code 49650

When billing for CPT code 49650, it is vital to ensure that specific guidelines and rules are followed. Claims for this procedure should be supported with complete and accurate documentation. If the procedure is performed bilaterally, modifier 50 must be added to indicate this. Payer-specific guidelines or requirements for billing this code should also be considered.

Historical Information and Similar codes to CPT Code 49650

The Current Procedural Terminology (CPT) system added code 49650 on January 1, 2000. Since then, the code hasn’t changed. CPT codes similar to 49650 include 49651, 49560, 49561, 49565, and 49566, each describing different types of inguinal hernia repair procedures.

Examples of CPT Code 49650

The following are four scenarios in which CPT 49650 might be used:

  • A 55-year-old male with bilateral inguinal hernia undergoing laparoscopic repair with mesh on both sides,
  • a 40-year-old female with right inguinal hernia with a history of several abdominal procedures successfully undergoing laparoscopic mesh repair,
  • a 70-year-old female with left inguinal hernia with a history of multiple abdominal operations successfully undergoing laparoscopic repair without mesh, and
  • a 60-year-old male with left inguinal hernia and obesity who, after evaluating the risks and benefits, undergoes laparoscopic repair with mesh.

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