Wiki Coding question for hernia

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DebbieP

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Hello - Can someone assist me with a coding question? We boarded a umbilical hernia repair but the surgeon didn't find one, he did complete a diagnostic laparoscopy. Can someone help me with the ICD-10 - which I'm thinking is I can only code the symptoms i.e. abdominal pain? Has everyone coded this before? Thank you
 
You are correct - if the provider states that no hernia was found, you cannot code that as a diagnosis and would need to code the symptoms or other indications that made the surgery necessary.
 
Regarding Inguinal Hernia repair mesh codes in ASC..Please help me!

Hello AAPC Members,

I need your advise in coding the hernia repair surgeries. I work in ASC facility and the doctor performed open incarcerated inguinal hernia repair with BARD/Ventralex mesh implant. So i have the codes as 49507 for the procedure. Now i am confused which codes to give for the implant. Can i give (two codes as 15777 with Q4100 for application of biologic implant) or (only one HCPCS code "C1781" for the mesh). Also, i read somewhere that we cannot give 15777 with Q4100 especially for ventral/incisional hernia repairs as we have 49568 for implantation of mesh.

Please I need your help whoever see this post, kindly share your feedback for "Inguinal hernia repair mesh implant code". Also, please provide any resources if you have.

Thank you,
 
Sri said:
Hello AAPC Members,

I need your advise in coding the hernia repair surgeries. I work in ASC facility and the doctor performed open incarcerated inguinal hernia repair with BARD/Ventralex mesh implant. So i have the codes as 49507 for the procedure. Now i am confused which codes to give for the implant. Can i give (two codes as 15777 with Q4100 for application of biologic implant) or (only one HCPCS code "C1781" for the mesh). Also, i read somewhere that we cannot give 15777 with Q4100 especially for ventral/incisional hernia repairs as we have 49568 for implantation of mesh.

Please I need your help whoever see this post, kindly share your feedback for "Inguinal hernia repair mesh implant code". Also, please provide any resources if you have.

Thank you,
Click to expand...

Placement of the mesh during an inguinal hernia repair is inclusive to the procedure, so the physician may only report 49507. Procedure code 15777 is for use only for skin procedures of the breast or trunk and would not be appropriate here. For a reference, please see CPT Assistant, October 2013, which states "15777 is for soft tissue reinforcement and is only intended for use with the Integumentary System section of codes. Therefore, it is not appropriate to report code 15777 in conjunction with codes for various procedures outside the Integumentary System, such as pericardium repair, hernia repairs, arteriotomy/venotomy repair, tendon repair, tonsillar repair following tonsillectomy, or any soft tissue reinforcement of organs (such as liver, kidney, pleura, peritoneum, gallbladder)."

A facility should report the mesh as a supply cost as it would any other costs per your payers' guidelines. C1781 would be appropriate, but Q4100 is not correct as a mesh is not a skin substitute. But I think you will find that the reimbursement for this supply is usually inclusive or packaged to the grouper or case rate assigned to the hernia repair surgeries for ASC and outpatient facilities, so there will not be a separate payment made for the mesh itself.
 
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