CPT CODES

CPT Code 49622

CPT code 49622 is for repairing a parastomal hernia without complications or stricture during a surgical procedure.

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What is CPT Code 49622

CPT code 49622 is used to describe the surgical procedure for the repair of a parastomal hernia, which is a type of hernia that occurs near a stoma (an opening created surgically to allow waste to exit the body). This specific code indicates that the repair is performed without the use of a mesh or other reinforcing material, and it typically involves the correction of the hernia and the restoration of the abdominal wall integrity.

Does CPT 49622 Need a Modifier?

For CPT code 49622, which pertains to the repair of a parastomal hernia, the following modifiers may be applicable:

1. Modifier 22 - Increased Procedural Services: Used when the work required to perform the procedure is substantially greater than typically required.

2. Modifier 51 - Multiple Procedures: Indicates that multiple procedures were performed during the same surgical session.

3. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.

4. Modifier 53 - Discontinued Procedure: Indicates that the procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.

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 62 - Two Surgeons: Indicates that two surgeons worked together as primary surgeons performing distinct parts of a single reportable procedure.

7. Modifier 66 - Surgical Team: Used when a team of surgeons is required to perform the procedure.

8. Modifier 76 - Repeat Procedure by Same Physician: Indicates that a procedure or service was repeated by the same physician subsequent to the original procedure or service.

9. Modifier 77 - Repeat Procedure by Another Physician: Indicates that a procedure or service was repeated by another physician subsequent to the original procedure or service.

10. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Used when a related procedure is performed during the postoperative period of the initial procedure.

11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Indicates that an unrelated procedure or service was performed by the same physician during the postoperative period.

12. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.

13. Modifier 81 - Minimum Assistant Surgeon: Indicates that a minimum assistant surgeon was required during the procedure.

14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required and a qualified resident surgeon is not available.

15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Indicates that a non-physician provider assisted in the surgery.

These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.

CPT Code 49622 Medicare Reimbursement

CPT code 49622 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS), indicating that it is a covered service. However, coverage and payment may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. Providers should consult their local MAC for detailed guidance on billing and reimbursement for this procedure.

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