August 22, 2019
I placed a non-biological implant for abdominal soft tissue reinforcement. Can this be coded as +15777?
No. Code +15777 is reported specifically for a biological implant for soft tissue reinforcement implant in breast or trunk only. Code +0437T, a Category III code, is reported for implantation of a nonbiologic or synthetic implant (eg, polypropylene) for fascial reinforcement of the abdominal wall. A Category III code is intended as a temporary or tracking code, and payment is carrier determined. Payors may consider Category III codes to be investigational and therefore not covered. To increase chance of payment, have always have the procedure pre-authorized.
*This response is based on the best information available as of 08/22/19.