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Laparoscopic Excision of Intra-muscular Mass with Repair of Resulting Hernia

Camille Posted Thu 16th of May, 2019 17:03:26 PM
The surgeon performed a Laparoscopic Excision of an intramuscular abdominal mass-then repaired the Resulting Ventral Hernia Defect with Mesh, laparoscopically & in the same session. Question #1) Which CPT captures a Laparoscopic Abdominal Muscle Mass Excision? I believe I should look to complex closure codes (instead of Ventral Hernia) for the defect repair. Question #2) Are CPT 13100-13102 appropriate for a Laparoscopic Complex Closure? If not, what would you recommend? "After achieving pneumoperitoneum...the mass could be seen bowing out the peritoneum...the peritoneum and transversalis muscle were dissected free from the anterior abdominal wall using electrocautery and blunt dissection. This peritoneal and transversalis muscle flap was dissected down past the mass. The mass was again identified. This was then excised using electrocautery, taking care to excise the entire mass...Attention was then turned to repairing the resulting ventral hernia. She had a defect of approx.. 3.5 to 4 cm in diameter in the left lower quadrant. A piece of ProGrip mesh was brought onto the field. This was placed underlying the defect with good overlap...Once the mesh was placed, it was trimmed to size and noted to lay nicely with good coverage of the defect. The peritoneum overlying the mesh was then closed so the mesh was not exposed... Thank you.
SuperCoder Answered Fri 17th of May, 2019 02:52:43 AM

Hi Camille,

As per the above documentation the appropriate code for the above performed procedure will be 49652 (Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible. We will use modifier 22 (increased procedural services) for the additional work done. Rest the repair, mesh and suturing is all inclusive in CPT 49652.

 

Feel free to ask for any further query.

 

Camille Posted Fri 17th of May, 2019 13:49:58 PM
Is the intramuscular mass excision is bundled into the Hernia Repair? Thank you.
SuperCoder Answered Mon 20th of May, 2019 03:41:15 AM

Hi Camille,

There is no exact CPT code for laparoscope removal of abdominal mass. Also, there was no separate incision or session for removal of this mass, so we will go for 49652-22 (for the additional work of mass removal - same session). Hope it help

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