tci General Surgery Coding Alert - 2010 Issue 1

READER QUESTIONS : Zero In on Diaphragmatic Hernia Repair Code

Question: I'm having an issue with an insurance company overpayment for a laparoscopic diaphragmatic hernia repair. We're billing 39599, but they're saying we should use 49659. Who is correct? Florida Subscriber Answer: CPT 2010 introduced two new codes for lap paraesophageal or diaphragmatic hernia repairs, so you should select the correct code from these, as of Jan. 1: • 43281 -- Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh • 43282 -- ... with implantation of mesh. Check the date: If you're talking about a past claim denial from prior to Jan. 1, you...

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