Our practice is also now visiting this scenario and we agree that the 15734 is not a 100% code, so therefore, should not be used. For our surgeons we are going to go with the 49999 as recommended here as well. We also have another component to this. Our provider has used Veritas bovine pericardium mesh as well. We are wondering if the add-on code 49568 provides accurate reimbursement for this. Some of our providers use Alloderm, which we use an unlisted code for this as recommended by the AMA through the General Surgery Coding Alert publication. Any thoughts if we should go the same route with the Veritas "mesh". We currently are using the 49568 add-on code.
One more question too... if basing the unlisted on the 15734 as a comparison, the RVUs for the incisional/ventral hernia repairs are less than the 15734 RVUs. So, would you code the 49999 as the primary procedure and get stuck with what ever the payer reimburses for unlisted codes or still post the hernia as the primary with the unlisted component separation as a secondary code?