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General Surgery Coding Alert

Reader Question:
+15777 vs. 49568 Depends on Purpose

Question: Our surgeon repaired an initial incarcerated incisional hernia and closed with a myofascial advancement flap using acellular xenograft (surgimend). Should we code the xenograft as +15777 or 49568?Utah SubscriberAnswer: The answer depends on how the surgeon used the xenograft -- was the xenograft mesh for the hernia repair, or was it to shore up the advancement flap and help with healing? Your surgeon's documentation should point you in the right direction. Code the case: You should bill the hernia repair as 49561 (Repair initial incisional or ventral hernia; incarcerated or strangulated) and the flap as 15734 (Muscle, myocutaneous, or fasciocutaneous flap; trunk).Hernia repair: If the surgeon uses the xenograft mesh for the hernia repair, report +49568 (Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection [List separately in addition to code for the incisional or [...]

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