tci Part B Insider - 2012 Issue 3

Hernia Coding: Mesh Coding Doesn't Have to Be Difficult--If You Follow These 4 Steps

Modifier 22 is the choice for difficult removal during hernia repairMesh placement may be common during hernia repair, but you can only bill separately for the procedure in a minority of cases. Make sure you know what they are.1. Claim Placement With Incisional/Ventral HerniaYou may report separate placement of mesh (+49568, Implantation of mesh or other prosthesis for incisional or ventral hernia repair) only when the surgeon repairs an incisional or ventral hernia. Get the specifics: Report 49568 with 49560 (Repair initial incisional or ventral hernia; reducible), 49561 (... incarcerated or strangulated), 49565 (Repair recurrent incisional or ventral...

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