If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Surgeon does a sling procedure for stress incontinence on a female patient. This is a biologic sling and not synthetic. I know the sling is 57288, but should I also code 15275 for application of the Xenform?
CPT 15275 is for skin substitute graft application for wound healing purposes. Since this is not the intent of a sling for incontinence, i don't think that this code would be appropriate.
My surgeon keeps wanting to bill separately for the xenograft. Questioned using 15777 but this is for integumentary, right? The closest code I could find to use with biologic mesh used with urinary sling is 57267. But this is an add on code and 57288 cannot be used as its primary. Can we even bill for the xenograft? I can't find anything in writing telling me one way or the other.
Is there any additional work being done compared to a traditional synthetic sling and that's what he feels he should bill extra and be paid extra for?
Are you purchasing the xenograft and looking to be reimbursed for the supplies?
I guess what I don't get, because I've only ever billed for synthetic sling placement, is what is the reason that the provider feels they should be reimbursed on another CPT code over and above a synthetic sling placement?
Can you post an op note for one of the biologic sling placements too? It might help understand what the difference is between the two types of sling placements. Thanks.
Good. You seem to have all of the same problems with billing this that I do. I'm glad it's not just me. This physician just started wanting to bill this a few months ago. I don't see why you would bill any different for a biologic sling than you would for a synthetic one. There doesn't seem to be any additional work done. I just wanted to make sure there wasn't something I was missing. These procedures are being done in the hospital, so the physician practice would not be purchasing the material. If anyone should be billing for that, I would think the hospital would.