General Surgery Coding Alert
Mesh Removal Code Isn't for Hernia
Texas Subscriber
Answer: Anyone using +11008 (Removal of prosthetic material or mesh, abdominal wall for necrotizing soft tissue infection [list separately in addition to code for primary procedure]) during recurrent hernia repair isn't doing so successfully.
That's because 11008 is an add-on code meant to accompany only 11004-11006, which describe debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection. These are extensive (and relatively rare) procedures performed on high-risk patients for conditions such as Fournier's gangrene (608.83). Recurrent hernia repair may occur during such a procedure, but it is incidental to the debridement, and you should therefore not report it separately.
Likewise, the surgeon may remove mesh placed during a previous hernia repair during these extensive debridements--for which you may report 11008--but mesh removal in this case is related to the debridement, not to any subsequent hernia repair.
Bottom line: You should not attempt to report 11008 with any hernia repair codes (for instance, 49520, Repair recurrent inguinal hernia, any age; reducible).
Keep reading: For a complete discussion of mesh removal with recurrent hernia repair, look to next month's General Surgery Coding Alert.
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