General Surgery Coding Alert
What's the Choice for Lap Ventral Hernia?
Georgia Subscriber
Answer: You should select 49659 (Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy) for the hernia repair.
Choose the unlisted-procedure code because only inguinal hernias include codes to describe laparoscopic repair (49650, Laparoscopy, surgical; repair initial inguinal hernia). Likewise, you should stay away from 49560 (Repair initial incisional or ventral hernia; reducible) because the code descriptor does not specify "laparoscopic."
As in all cases when you report an unlisted-procedure code, you should provide full documentation with your claim describing the exact nature and extent of the procedure. In this case, you should also document mesh placement during the procedure as an additional step in the surgery. For instance, you could describe the procedure as "lap ventral hernia repair with mesh" and charge accordingly.
You may be tempted to report +49568 (Implantation of mesh or other prosthesis for incisional or ventral hernia repair [list separately in addition to code for the incisional or ventral hernia repair]) in addition to 49659, but you should resist the temptation. Code 49568 is an add-on code for use with incisional and ventral hernia repair codes only. You should not report 49568 with an unlisted-procedure code.
General Surgery Coding Alert
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What's the Choice for Lap Ventral Hernia?
Question: Using a laparoscope, the surgeon repaired an incarcerated ventral hernia with implantation of mesh. [...] - READER QUESTIONS:
There's No Modifier for Incident-to
Question: Should I use a modifier when reporting services provided incident-to the surgeon's care?
Utah Subscriber
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Question: A patient sees a surgeon in our group practice. Over two years later, the [...] - READER QUESTIONS:
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Question: Is there any way we can charge for a visit to discuss a patient's [...] - READER QUESTIONS:
Big Needle Equals Incision
Question: The surgeon removed a fishhook by inserting an 18-gauge needle into the puncture. Should [...] - READER QUESTIONS:
Supplies Are Included in GI Procedures
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Mark India Ink on Claim With 45381
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22 is an Option for Difficult Lap Chole
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The following supplement to General Surgery Coding Alert is the transcript of a teleconference presented [...]
