# mesh placement w/o hernia repair



## buppkl (Sep 30, 2011)

I asked this question earlier with no responses so I thought maybe if I worded it differently someone would offer some opinions on how to code this. Doc did small bowel resection on a patient that had an incarcerated hernia repair with mesh placement 8 days prior. At the time of the 1st surgery a small bowel obstruction was noted but it was felt better to leave and see if it resolved on it's own. Unfortunately pt had to return to OR for a bowel resection. At that time the mesh from previous hernia repair was removed, small bowel was resected, a bilateral separation of components was done and a piece of Alloderm mesh overlay was placed before closing the abdomen. Would this alloderm be billable for the doc? Doc states in his procedure heading that an incisional hernia repair w/ mesh was done but I disagree with billing another hernia repair. He went in to do the bowel resection and placed another piece of alloderm as reinforcement for the abdominal wall. There was no recurrence of a hernia. Without a hernia repair the mesh would not be billable but since this is a synthetic material used as a mesh, would that change the billing? I am leaning towards not billing since this was not used  as a wound closure/skin replacement but rather a mesh. My codes are 15734-Rt, 15734-Lt, 44120.
Anyone?


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## FTessaBartels (Oct 4, 2011)

*I would NOT bill a second hernia repair*

It sounds like he was opening the previous incision as his approach to the bowel obstruction. I would NOT code a second hernia repair.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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