Wiki Placement of Inguinal Mesh without hernia repair

[TnRushFan]

Good morning,

I am in a quandary...any insight will be appreciated.
The provider clearly documents no hernia, no defect, no areas of weakness...but then places mesh anyway?
How can I capture the mesh insertion without hernia repair...am leaning toward 154xx from integumentary system codes but not sure???

POST-OP DX: Right Cord Lipoma
PX: Open Right Inguinal Hernia Repair with Mesh

*inspected the floor of the inguinal canal and identified no defects or areas of weakness
*no hernia sac was identified and the internal ring was well intact
*prior mesh repair of the laparoscopic hernia repair - intact
*identified a cord lipoma distally, and resected that from the spermatic cord.
** then placed a piece of ProGrip mesh and secured to the pubic tubercle

Post Op Note:
informed him that his prior repair was intact and that his bulge was likely from a cord lipoma

Thanks in advance...

 

[thomas7331]

I think you have two choices that I can see here - you can code this for the excision of the cord lipoma with CPT 55520 and consider the mesh inclusive to the procedure (as it would be for an open inguinal hernia repair), or code it with an unlisted code 49999 and request that the payer make payment comparable either to 49520 (due to the documentation of a prior hernia at this site), or to 55520 plus 49568. Personally I prefer to avoid unlisted codes if at all possible so would probably go with the first. This is not an integumentary system surgery so I don't think the use of the 15xxx series codes would be appropriate. The mesh is part of the closure and repair, not a separate procedure in and of itself. Perhaps others will have additional suggestions?