tci General Surgery Coding Alert - 2007 Issue 10

Reader Question ~ Mesh Add-on Can't Stand Alone

Question: We-ve had a rash of infected mesh cases recently, and our physicians want to report 49568 for this. But this is an add-on code, and we cannot report it alone. Some folks in the office have suggested reporting a recurrent hernia repair in addition so that we can claim 49568. But hernia repair isn't documented, just mesh removal and replacement. How should we report these procedures?Arizona Subscriber Answer: First, you must never code for anything that the surgeon didn't actually do or that documentation cannot substantiate. Filing false claims can cost your practice triple damages in paybacks...

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