How To Use CPT Code 49557

CPT 49557 describes the surgical repair of a recurrent femoral hernia that is incarcerated or strangulated. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 49557?

CPT 49557 can be used to describe the surgical repair of a recurrent femoral hernia that is incarcerated or strangulated. This code is used when the provider performs a procedure to repair the hernia and restore the normal anatomy of the affected area.

2. Official Description

The official description of CPT code 49557 is: ‘Repair recurrent femoral hernia; incarcerated or strangulated.’

3. Procedure

1. The provider makes an incision in the groin area on the previous skin scar.
2. He carefully dissects around the hernia sac and assesses the previously placed mesh and any adhesions from the previous surgery.
3. The provider releases the scar tissue around the neck of the hernia sac to reduce pressure on its contents.
4. He dissects the surrounding structures from the hernia sac and opens the sac to check its contents.
5. The provider determines the extent of viable tissue remaining in the hernia and reduces the hernia sac, putting it back in its proper anatomical position.
6. If the patient requires intestinal resection, that service is separately reportable.
7. The provider checks for bleeding, removes any instruments, and closes the incision in the groin.

4. Qualifying circumstances

CPT 49557 is used for the repair of a recurrent femoral hernia that is incarcerated or strangulated. This means that the hernia is trapped or its blood supply is cut off. The procedure is performed by a provider who carefully assesses the hernia and surrounding structures to determine the appropriate course of action.

5. When to use CPT code 49557

CPT code 49557 should be used when a provider performs a surgical repair of a recurrent femoral hernia that is incarcerated or strangulated. It is important to accurately document the specific circumstances of the hernia and the procedure performed.

6. Documentation requirements

To support a claim for CPT 49557, the provider must document the following information:

• Description of the recurrent femoral hernia and its incarceration or strangulation
• Details of the surgical repair procedure, including the incision, dissection, assessment of previously placed mesh and adhesions, release of scar tissue, reduction of the hernia sac, and closure of the incision
• Any additional procedures performed, such as intestinal resection
• Documentation of any complications or unexpected findings during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 49557, ensure that the procedure meets the criteria for a recurrent femoral hernia repair that is incarcerated or strangulated. It is important to accurately document the specific circumstances and details of the procedure. Modifier 50 should be used for bilateral procedures. Be aware of any additional codes that may be separately reportable, such as intestinal resection.

8. Historical information

CPT 49557 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates to the code since its addition.

9. Examples

1. A surgeon performs a surgical repair of a recurrent femoral hernia that is incarcerated in a 45-year-old patient.
2. A provider performs a surgical repair of a recurrent femoral hernia that is strangulated in a 60-year-old patient.
3. A surgeon performs a surgical repair of a recurrent femoral hernia that is incarcerated in a 70-year-old patient.
4. A provider performs a surgical repair of a recurrent femoral hernia that is strangulated in a 55-year-old patient.
5. A surgeon performs a surgical repair of a recurrent femoral hernia that is incarcerated in a 50-year-old patient.
6. A provider performs a surgical repair of a recurrent femoral hernia that is strangulated in a 65-year-old patient.
7. A surgeon performs a surgical repair of a recurrent femoral hernia that is incarcerated in a 55-year-old patient.
8. A provider performs a surgical repair of a recurrent femoral hernia that is strangulated in a 75-year-old patient.
9. A surgeon performs a surgical repair of a recurrent femoral hernia that is incarcerated in a 60-year-old patient.
10. A provider performs a surgical repair of a recurrent femoral hernia that is strangulated in a 70-year-old patient.