General Surgery Coding Alert

Answer: No, 49085 (Removal of peritoneal foreign body from peritoneal cavity) is not appropriate (and refers to the peritoneum rather than the abdomen). To report removal of infected mesh in this location, report either 20680 (Removal of implant; deep [e.g., buried wire, pin, screw, metal band, nail, rod or plate]) or 49999 (Unlisted procedure, abdomen, peritoneum and omentum).

If you use 49999, be sure to include an operative note to fully describe the procedure. The payer will make a reimbursement determination based on the documentation provided. When you use 20680, you may wish to append modifier -22 (Unusual procedural services) if documentation supports the argument that the removal was more involved than that typically required for a wire, pin, metal band, etc.