More than one million hernia repair (herniorrhaphies) are performed worldwide each

year
(US FDA 2017). A physician may perform one of three common types of repairs. The
first
type is the traditional or conventional repair. Under general anesthesia, the
physician pushe
the bulging tissue back into the abdominal cavity. Pulling together and stitching
the surround�
ing mu cle and ligaments close the defect. A recovery period of four to six weeks i
usually
needed.

The second type of herniorrhaphy uses mesh rather than stitches to repair the
abdominal
defect. Because stitches are not used, the patient experiences less postoperative
pain. Com�
monly used meshes are Marlex and Prolene. When coding a mesh repair of an
incisional or
ventral hernia, code 49568, Implantation of mesh or other prosthesis for incisional
or ventral
hernia repair, must be as igned in addition to the repair code. Th u e of me h with
other her�
nia repairs is not coded.

The third type of hernia repair i performed by a laparoscope. The laparo copic
repair
technique (49650-49659) is used to treat inguinal, ventral and inci ional hernias.
Le s discom�
fort and faster recovery are the main advantages to this approach. As with other
endoscopie ,
a surgical laparoscopy includes a diagnostic laparoscopy.

It is important to note that diaphragmatic and hiatal hernia are not a igned to the
diges�
tive system. To identify these hernias, the coder should use codes from the 39501-
39541 series
in the diaphragm subsection of the CPT code book.

If the repair of a strangulated hernia includes associated repair of other organs,

an addi�
tional code should be used for the other repair.

The parenthetical statement under code 54640 Orchiopexy, inguinal approach, with Ok

without hernia repair, provides confusion to coder when coding orchiopexy and
inguinal
hernia repair, but CPT Assistant (June 2008, March 2004, and January 2004) directs
the codes�
to code both procedure (54640) and the appropriate inguinal hernia repair if they
are bot
performed.