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Coding for Mesh repair when using Alloderm

  1. #1
    Default Coding for Mesh repair when using Alloderm
    Exam Training Packages
    Wondering if anyone is coding 15330 when using Alloderm as bioactive mesh during a complex incisional hernia repair or 49568...or both. Having quite a discussion on the appropriate way to code.

  2. Default Alloderm mesh
    Hi Donna,

    15xxx is not appropriate because this code series is for skin replacement. In this instance, the alloderm is being used to close the fascia. If it is not bundled, 49568 is the appropriate code, as it is for implant of mesh "or other prosthesis" The Alloderm vendor has been promoting the 15xxx frequently, but from a CPT coding principles perspective, 15xxx is only correct when used for skin replacement. Using alloderm for fascial defects needs to be coded to the appropriate system.

  3. #3
    Vancouver Washington
    I disagree. My docs use Surgisis (biomesh) during hernia repairs often. When they use a prosthetic mesh I use 49568,(the rest bundle) but this code can only be used when using codes 49560-49566. When they use biomesh I do use the 15xxx codes. Here is a clip from an article:

    Richard J. Kagan, MD, FACS, Chief of Staff, Shriners Burns Hospital;

    Director, University Hospital Burn Center; and Professor of

    Surgery, University of Cincinnati Medical College of Medicine,

    Cincinnati, Ohio reviewed the new/revised codes approved by the

    CPT Editorial Panel. Dr. Kagan reminded symposium attendees

    that xenografts are tissue transplanted from one species to

    another species and presented the new CPT® definition of

    xenografts — ie, “Application of a non-human skin graft or

    biologic wound dressing (eg, porcine tissue or pigskin) to a part of

    the recipient's body following debridement of the burn wound or

    area of traumatic injury, soft tissue infection and/or tissue

    necrosis, or surgery.”

    Although these codes are often used for skin grafts, they are not limited to this. We do have to fight some insurance companies and send in articles, but we always prevail. This is just my opinion

    Jaime Wicklund, CPC

  4. #4
    I found this in an article "49568 is an add on code for placement of mesh. it does not specify TYPE of mesh, therefore it would be appropriate to bill 49568 for the placement of the biological mesh."

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