CPT code 49614 is for the repair of a hernia with a mesh, specifically for a recurrent hernia that is less than 3 cm in size.
CPT code 49614 is used to describe the surgical procedure for the repair of an abdominal hernia that is classified as a recurrent hernia, specifically when the hernia is less than 3 centimeters in size. This code indicates that the repair is being performed on a hernia that has previously been treated but has returned, and it involves a specific technique to address the hernia's recurrence.
For CPT code 49614, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Used when the work required to provide a service is substantially greater than typically required.
2. Modifier 50 - Bilateral Procedure: Used when the procedure is performed on both sides of the body.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session.
4. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician: Used when a procedure or service is repeated by the same physician or other qualified healthcare professional.
7. Modifier 77 - Repeat Procedure by Another Physician: Used when a procedure or service is repeated by another physician or other qualified healthcare professional.
8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician: Used for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used for an unrelated procedure or service by the same physician during the postoperative period.
10. Modifier LT - Left Side: Used to identify procedures performed on the left side of the body.
11. Modifier RT - Right Side: Used to identify procedures performed on the right side of the body.
12. Modifier XS - Separate Structure: Used to indicate a service that is distinct because it was performed on a separate organ/structure.
13. Modifier XE - Separate Encounter: Used to indicate a service that is distinct because it occurred during a separate encounter.
14. Modifier XP - Separate Practitioner: Used to indicate a service that is distinct because it was performed by a different practitioner.
15. Modifier XU - Unusual Non-Overlapping Service: Used to indicate a service that is distinct because it does not overlap usual components of the main service.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 49614 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS), indicating that it is a covered service. However, reimbursement may vary depending on factors such as geographic location and the specific Medicare Administrative Contractor (MAC) overseeing the claim. Providers should consult their local MAC for specific coverage and payment guidelines related to this procedure.
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