49613 Insurance Policy Changes

CPT 49613, in plain terms, covers Repairing a small abdominal wall hernia (less than 3 centimeters) using a direct closure technique. CPT 49613 is referenced in 3 tracked payer policy changes from Aetna and Providence Health Plan. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 49613 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 49613 on AAPC