Brazilian Liopabdominplasty

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I have a suction-assisted Brazilian Lipoabdominoplasty with a simultaneous repair of incisional hernia, and I do not code these! We will be billing the patient directly for the cosmetic procedure and the insurance plan for the hernia repair. I am stuck on which CPT to use for the cosmetic procedure, and would love some assistance!

She was placed in a prone position
and liposuction was performed on the hip rolls using HydraSolve and then removing
approximately 2 liters from each hip roll and grasping 1200 mL below the hip roll
tethering into the buttock region. The midline incision was closed with simple
interrupted 4-0 nylon sutures. She was then placed in the supine position, prepped,
padded, and draped in appropriate sterile fashion. Three liters was commenced into the
abdomen, HydraSolve liposuction was performed and then a Brazilian
lipoabdominoplasty was performed with a lower abdominal incision to the umbilicus
resecting the skin from the umbilicus to the pubis and creating a tunnel to the
epigastrium and epigastric incisional hernia was found. This was repaired with 0 Vicryl
and then the rectus diastasis was repaired with #1 Stratafix suture from the epigastrium
to the umbilicus and to the umbilicus to the pubic region. TAP blocks were used with
Exparel using 20 mL of Exparel mixed with 80 mL of sterile injectable saline performing
TAP blocks on each side and into the rectus sheath. The skin was then pulled inferiorly
and Scarpa's fascia was closed with 0 Stratafix suture. The umbilicus was brought out
through the midline, an incision 10 x 12 cm above the pubic incision. This was sewn in
place with 3-0 PDS deep dermis and a running subcuticular and Xeroform packing. A 4-
layer closure was performed in the lower abdominal incision with 3-0 Monoderm
Stratafix in the subcu, 3-0 Monoderm Stratafix in the deep dermis followed by a running
subcuticular 4-0 Monocryl in the middle one-third of dermis followed by Prineo tape.
The drains had been brought out laterally to the lateral portion of the abdominoplasty
incision. These were 10 mm flat Blake drain. It was sutured in place with 3-0 nylon.
She tolerated the procedure well.

I am not sure if it is appropriate to use 15830, +15847, and 15877.

Thank you for your help!
 

CodingKing

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incidental hernia repair is bundled into an abdominal procedures so I don't think you can bill it either. The cosmetic codes look right though.
 
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Samfoster

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Same procedure but for small hips

We're billing a similar scenario right now. Tummy tuck with liposuction on back and sides in prone position and liposuction on stomach and flanks in supine position. Then fat transfer to hips using 20926. The liposuction is 15877 and 15877-59. How many times can this be billed? Would the prone and supine each be their own 15877 like I have coded it or would it be just one? Could we bill 15877, 15877-59 x 3 for each area: 1)back 2)sides 3)stomach 4)Flanks?
 
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