49505 Insurance Policy Changes

CPT 49505, in plain terms, covers Repairing an internal hernia that requires opening the abdomen in a patient older than five years old. CPT 49505 is referenced in 3 tracked payer policy changes from Providence Health Plan and New Jersey Medicaid. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 49505 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 49505 on AAPC