vmounce
Guru
Can we bill for Goretex Mesh with inguinal Hernias? Use L8699? Also, is lipoma of the cord allowed to be billed with hernia procedure?
Appreciate any information.
Vickie Mounce
Appreciate any information.
Vickie Mounce
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Wiki Help on inguinal hernia repairs
- Thread starter vmounce
- Start date
Jamie Dezenzo
True Blue
Per commerical contracts we bill mesh....see C1781
CPT 55520 bundles per CCI edits but can break out with 59 if separate.
CPT 55520 bundles per CCI edits but can break out with 59 if separate.
vmounce
Guru
So, if it is same incision it is still okay to bill for inguinal hernia and lipoma of the cord?
This really confuses me.
Vickie
This really confuses me.
Vickie
Jamie Dezenzo
True Blue
I don't
Jamie Dezenzo
True Blue
Yes, this has been disputed....
Per General Surgery Alert (Jan 2008) Question
Is Lipoma Excision Separate with Hernia Repair?
Question: During an inguinal hernia repair (49505) with mesh, the surgeon preforms an excision of a lipoma of the spermatic cord. Should I report an additional code for the excision? The pathology report shows the specimen is a "hernia sac" and final diagnosis is "fibroadipose tissue". Pennsylvania Subscriber
Answer: Code 55520 (Excision of lesion of spermatic cord -separate procedure) properly describes excisions of the type your surgeon performed. But 55520 is a designated "separate procedure" that occurs here with a related primary procedure, the hernia repair 49505 (Repair initial inguinal hernia, age 5 yrs or older; reducible). Therefore, correct coding dictates that you bundle the excision into the hernia repair.
In short: You would report only the hernia repair, as usual, using 49505, with no additional code for the excision of the spermatic cord lipoma.
I did notice 55520 now bundles per CCI Version 17.1 (April 2011)
Per General Surgery Alert (Jan 2008) Question
Is Lipoma Excision Separate with Hernia Repair?
Question: During an inguinal hernia repair (49505) with mesh, the surgeon preforms an excision of a lipoma of the spermatic cord. Should I report an additional code for the excision? The pathology report shows the specimen is a "hernia sac" and final diagnosis is "fibroadipose tissue". Pennsylvania Subscriber
Answer: Code 55520 (Excision of lesion of spermatic cord -separate procedure) properly describes excisions of the type your surgeon performed. But 55520 is a designated "separate procedure" that occurs here with a related primary procedure, the hernia repair 49505 (Repair initial inguinal hernia, age 5 yrs or older; reducible). Therefore, correct coding dictates that you bundle the excision into the hernia repair.
In short: You would report only the hernia repair, as usual, using 49505, with no additional code for the excision of the spermatic cord lipoma.
I did notice 55520 now bundles per CCI Version 17.1 (April 2011)
codedog
True Blue
glad to know this ,thanks,guess info I had was outdated- SORRY-deleted info
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