Wiki Seprafilm - Is it seperately reportable?

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I have surgeons who are placing seprafilm during open abdominal & pelvic surgeries. The purpose is to prevent adhesions from attaching to your organs. Does anyone know if this is seperately reportable? If so what CPT code is used? This procudure only takes about 5-10 minutes to place the film. I don't believe that this is seperately reportable but I wanted to see if anyone else out there is billing for it.
 
Seprafilm - is it billable?

Has anyone determined whether seprafilm application can be separately reported? And if so, what CPT code would you use?
 
No you can not bill for the seprafilm it is part of the surgery. If someone else has found a code let us know. But I have looked and searched and have not found one.

Jill Gibson, CPC
 
Mixed messages!

According to Dr. Christopher Senkowski, Medical Advisor to AMA RUC from the American College of Surgery:

"If the graft is placed to prevent skin from adhering to the tendon preventing contracture then the product is serving a soft tissue support function . If this is true then I think 15777 is appropriate."

However, Dr. Senkowski provided this response when the physician was using a biologic implant such as a graft, and this is actually in the language of the code description.

If the provider is employing a non-biologic product, then the CMS Administrators tend to provide very inconsistent guidance including the use of the hernia mesh code. Under +15777, EncoderPro advises:

Code first primary procedure
Excludes Application of skin substitute to an external wound (15271-15278)
Excludes Mesh implantation for:
Excludes Open repair of ventral or incisional hernia (49568)
Excludes Repair of devitalized soft tissue infection (49568)
Excludes Repair of pelvic floor (57267)
Plastic, Reconstructive, and Aesthetic Surgery

In short, I believe that an unlisted code may be the most appropriate. As such, I would urge you to prior authorize the service and intended code selections. There just is not a consensus on this yet. :rolleyes:

Mary Corkins
TRG
maryc@trgltd.com
 
Interesting about the tendon thing. I love asking questions on here. You guys always come up with something I hadn't even thought about. Any other surgical coders out there want to comment?
 
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