tci General Surgery Coding Alert - 2009 Issue 7

Reader Questions: Reserve +49568 for Incisional,Ventral

Question: I have a question about 49505 and 49568. I am billing these codes together and some payers are paying and others are not. Medicare is paying. What I can do about the other payers who are following CPTs rules? Texas Subscriber Answer: This is incorrect billing, even if you are getting paid by some payers. You should immediately stop billing 49505 and +49568 together. In fact, you should also refund the carriers that paid you for these codes together. Why? Add-on code +49568 (Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh...

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