General Surgery Coding Alert

Save it for fascia support in soft tissue.

If your surgeon frequently performs hernia repairs, you may have been delighted to spy new add-on code +15777 (Implantation of biologic implant [e.g., acellular dermal matrix] for soft tissue reinforcement [e.g., breast, trunk]) in CPT® 2012.

But make no mistake -- this code does not apply to mesh used in hernia procedures, said Christopher K. Senkowski, MD, at the CPT® 2012 Annual Symposium in Chicago during his Nov. 17 "CPT® Changes: General Surgery" seminar.

"New code +15777 was developed for areas where there's a defect from a tumor resection, or where there's a need for fascia support such as a breast situation -- it's not something you're going to use in conjunction with a hernia repair," he said.

Do this: Instead, report mesh implantation for hernia repairs with +49568 (Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection [List separately in addition to code for the incisional or ventral hernia repair]), as you did previously, he said.

Beware +15777 Limitations

"You should report this new code only when the surgeon uses the biological implant material with soft tissue repairs, not for other applications," says Marcella Bucknam, CPC, CCS-P, CPC-H, CCS, CPC-P, COBGC, CCC, manager of compliance education for the University of Washington Physicians Compliance Program in Seattle. Note that repairs other than breast or trunk may be considered "off label" at this time, and practices may need to submit peer review or other information to support the use of the product at other body sites.