General Surgery Coding Alert

Also get ready for 5 new/revised codes for your debridement claims

If you've been frustrated by lack of code detail to capture your surgeon's work for paraesophageal hiatal hernia repair, AMA CPT Codes 2011 will change that with six new codes that debut on Jan. 1.

Identify Hiatal Hernia Repair, Approach, Mesh

When your surgeon performs a Nissen fundoplication or Collis Nissen repair, you couldn't additionally capture the hernia repair or mesh placement -- until now. 

CPT 2011 provides six new codes to describe the details of your surgeons' paraesophageal hiatal hernia repair including fundoplication, open approach by laparotomy, thoracotomy, or thoracoabdominal incision, and mesh placement, if any. You can see the details in the following new codes:

• 43332 -- Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis
• 43333 -- ...with implantation of mesh or other prosthesis
• 43334 -- Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis
• 43335 -- ...with implantation of mesh or other prosthesis
• 43336 -- Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; without implantation of mesh or other
• 43337 -- ...with implantation of mesh or other prosthesis››

"The new codes will indeed be very helpful in coding hiatal hernias," says Myra P. Anderson, CPC, CCAT, CPAT, coding educator with Ochsner Health System. "The additional codes for paraesophageal hiatal hernias with approach, as well as the use of mesh, will more adequately describe the procedure performed."

Capture Large Area Debridement With New Codes

Small area or huge, your surgeon gets the same pay for debridement under current CPT codes. But CPT 2011 has revised current codes to include the size of the area debrided and introduces three new codes to describe additional area for large treatment zones. The changes are as follows:

• 11042 (Revised) - Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less
• 11043 (Revised) - Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less
• 11044 (Revised) - Debridement, bone (includes epidermis,dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less
• 11045 (New) - Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)
• 11046 (New) - Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)
• 11047 (New) - Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

More to come: That's just a quick foretaste of over 60 code revisions and additions that could impact your general surgery practice next year. Stay tuned to future issues of General Surgery Coding Alert for in-depth expert analysis of new coding solutions -- and dilemmas -- that CPT 2011 has in store for you.