tci General Surgery Coding Alert - 2006 Issue 7

Reader Questions: Mesh Isn't the Only Prosthesis for Hernia Repair

Question: How should I report the use of AlloDerm (human regenerative tissue), rather than Marlex mesh, during a ventral hernia repair? Should I still report 49568, or is another code more appropriate?California Subscriber Answer: In this case (when the surgeon uses AlloDerm instead of mesh for ventral hernia repair), you may consider the AlloDerm to be a prosthesis. Therefore, you may report the placement separately using +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]). Watch your claims: Remember, you...

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