Laparoscopy codes (49320-49329) are available in the CPT code book for procedures

on
the abdomen, peritoneum, and omentum that are not coded to more pecific
laparoscopic proce�
dures or more specific anatomic sites.

Hernia Repair

Many hernia repairs are coded in the last portion of the digestive system. An
abdominal hernia
occurs when internal organs, such as the intestine , break through a hole or tear
in the muscu�
lature of the abdominal wall. This protrusion produces a bulge that can be seen or
felt. Symp�
toms include burning and pain with activity. To code a hernia repair accuratel the
coder must
answer the following question :

1. What is the type or site of the hernia?

� Inguinal i a common herniation of the groin area (inguinal canal). Figure 4.21

displays the herniation of the intestine into the groin.

� Lumbar i a rare herniation occurring in the lumbar region of the torso.

� Incisional i a herniation at the site of a previous surgical incision.

� Femoral is a common herniation occurring in the groin area (femoral canal).

� Epigastric is a hernia located above the navel.

Umbilical i a herniation at the navel.

� Spigelian is a herniation usually located above the inferior epigastric vessel,

along
the outer border of the rectus muscle.

2. What is the age of the patient?

� Less than 37 weeks' gestation at birth, and now between birth and 50 weeks'
postconception age

� Under 6 months

� Six months to under 5 year

� Age 5 year or older

3. What is the history of the hernia?

� Initial refers to the first surgical repair of hernia

� Recurrent refers to a hernia that has been surgically repaired previously

4. What is the clinical presentation of the hernia?

� A reducible hernia i characterized by protruding organs that can be returned to

normal position by manipulation.
� A sliding hernia include the colon or cecum as part of the hernia sac. (In some
case, the urinary bladder al 0 may be involved.)

� An incarcerated hernia is one that cannot be reduced without urgical

intervention.

� A trangulated hernia is an incarcerated hernia in which the blood upply to the

contained organ i reduced. A strangulated hernia presents a medical emergency.