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HOW TO CODE PERISTOMAL HERNIA AND MIDLINE INCISIONAL HERNIA

Kathy k Posted Wed 21st of January, 2015 19:21:18 PM

PREOPERATIVE DX: PERISTOMAL HERNIA (569.69) AND MIDLINE INCISIONAL HERNIA (553.21).

PROCEDURE PERFORMED:
1) PERISTOMAL HERNIA REPAIR WITH BARD CK PERISTOMAL HERNIA PATCH, 12.5 X 15.5 CM, WITH A 28- TO 35-MM OPENING.
2)EXPLORATORY LAPAROTOMY EXCISION.
3)LYSIS OF ADHESION
4)INCISIONAL HERNIA REPAIR WITH OVERLAY POLYPROPYLENE MESH 3 X 6 INCH.

CPT CODES THE DOCTOR GAVE.
49560
49568
49560
49568

WOULD IT BE FEASIBLE TO BILL AS 49560, 49568, 49560-51, AND 49568-51?

SuperCoder Answered Fri 23rd of January, 2015 00:08:28 AM

We are researching and will get back to you ASAP. Thanks !!

SuperCoder Answered Fri 23rd of January, 2015 00:08:28 AM
Researching.
SuperCoder Answered Fri 23rd of January, 2015 10:23:53 AM

Hi,

Thanks for your patience.

You can report these codes if both repairs are performed at separate sites:

49560 553.21
49568 553.21
49560-51,59 569.69
49568-59 569.69

We can not use Mod 51 with 49568 as it is an add-on code and as per CPT guidelines we can't use modifier 51 with an add-on code.

Hope this answers your query.

Thanks

Kathy k Posted Fri 23rd of January, 2015 13:53:40 PM

Thank you! This helps alot!

SuperCoder Answered Fri 23rd of January, 2015 14:09:52 PM

You are welcome.

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