Use CPT 49505 to bill for an initial inguinal hernia repair procedure for patients five years or older.
1. What Is CPT Code 49505?
CPT 49505 covers an initial inguinal hernia procedure for a patient of five years or older. The provider reduces the hernia by pushing it back.
The CPT book describes the 49505 CPT code as: “Repair initial inguinal hernia, age five years or older; reducible.”
The patient is anesthetized and prepped before the provider makes an incision in the groin at the hernia site to perform the CPT 49505 procedure. Next, they use the incision to expose the inguinal, so the hernia can be identified.
Then, they identify the ilioinguinal nerve and move or mobilize it. They carry on by dissecting the spermatic cord and free it from the inguinal canal walls.
They continue the procedure by reducing the hernia to the level of the fascial defect with finger pressure in the patient’s inguinal region.
Then, the internal ring is closed, and the back wall (posterior) of the inguinal canal is repaired. Finally, they end the procedure by closing the incision, removing all the instruments, and checking for bleeding.
TIP: You can find all the CPT codes for inguinal hernia repair here.
4. Billing Guidelines
Use modifier 50 for bilateral procedures if the 49505 CPT code is performed on both sides.
CPT 49505 can only be billed for patients of five years or older. However, you can use CPT 49500 instead if the procedure was performed on a child between six months and five years of age.