Wiki Mesh Removal CPT

[youngva462@gmail.com]

I work at wound clinic (doctors office/professional, we bill under Medicare Part B). We have a patient who had an abdominal hernia repair some time ago performed by a provider outside our practice with the implementation of mesh. The patient comes to us for management of the surgical wound. The mesh has not taken and is visible through the patient's wound/skin. Our provider removed the mesh after several months of the mesh remaining to be exposed - there was no infection in the mesh. Our provider only removed the mesh, no hernia repair was performed and no new mesh was added.

Do yall have any suggestions as to what CPT code I should use for the removal of abdominal mesh due to exposure without infection?

Ive contemplated the following:
*20520 for removal of foreign body - but that is for muscle or tendons.
*49623 for remova of total or near total non infected mesh - but that is for at the time of hernia repair (which we only did a removal, no repairs)

 

[CBLENNIE]

49623 is an add-on code and so you can't use it for this scenario because the mesh removal is all that was performed. I don't see a CPT or HCPCS code that describes what your provider performed; you may need to look into an unlisted code of some type.