How To Use CPT Code 39560

CPT 39560 describes a surgical procedure that involves the resection and repair of the diaphragm using simple primary sutures. This article will provide an overview of CPT code 39560, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 39560?

CPT 39560 is a code used to describe a surgical procedure that involves the resection and repair of the diaphragm. During this procedure, a qualified healthcare provider removes diseased tissue, often caused by the intrusion of a tumor, from the diaphragm. The provider then repairs the diaphragm using simple primary sutures.

2. Official Description

The official description of CPT code 39560 is: ‘Resection, diaphragm; with simple repair (eg, primary suture).’ This code specifically refers to the surgical removal of tissue from the diaphragm and the subsequent repair using simple primary sutures.

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring they are appropriately prepped and anesthetized.
2. The provider makes an incision in the chest or abdomen to access the diaphragm.
3. Using retractors, the provider creates optimal visualization of the area by dividing and moving structures as necessary.
4. The diseased tissue is excised from the diaphragm, typically using electrocautery.
5. The provider then performs a simple repair of the diaphragm using primary sutures.
6. All bleeding is stopped, and the chest incision is closed in layers.

4. Qualifying circumstances

CPT 39560 is used when a patient requires the resection and repair of the diaphragm due to the presence of diseased tissue, often caused by the intrusion of a tumor. The procedure is performed by a qualified healthcare provider who has the necessary expertise in performing diaphragm surgeries. The patient must meet the specific criteria for this procedure, as determined by the healthcare provider.

5. When to use CPT code 39560

CPT code 39560 should be used when a healthcare provider performs a surgical resection and repair of the diaphragm using simple primary sutures. This code accurately represents the specific procedure involved in removing diseased tissue from the diaphragm and repairing it. It is important to ensure that the documentation supports the use of this code and that the procedure meets the necessary criteria.

6. Documentation requirements

To support a claim for CPT code 39560, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for diaphragm resection and repair
• Details of the procedure, including the specific techniques used
• Date of the procedure
• Any complications or unexpected findings during the procedure
• Details of the repair, including the use of simple primary sutures
• Any post-operative care instructions or follow-up appointments
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 39560, it is important to ensure that the procedure performed aligns with the specific requirements outlined in the code description. The healthcare provider should use the appropriate diagnosis codes to support the medical necessity of the procedure. It is also important to follow any specific billing guidelines provided by insurance carriers or regulatory bodies.

8. Historical information

CPT code 39560 was added to the Current Procedural Terminology system on January 1, 2000. The code has undergone no updates since its addition. However, it is worth noting that in 2017, it was added to the Inpatient Only (IPO) list for Medicare reimbursement purposes.

9. Examples

1. A qualified healthcare provider performs a resection and repair of the diaphragm using simple primary sutures to remove a tumor intrusion.
2. During surgery, the provider excises diseased tissue from the diaphragm caused by the presence of a tumor and repairs the diaphragm using simple primary sutures.
3. A patient undergoes a procedure in which the provider removes diseased tissue from the diaphragm and repairs it using simple primary sutures.
4. A healthcare provider performs a surgical resection and repair of the diaphragm, removing diseased tissue and using simple primary sutures for the repair.
5. During a surgical procedure, a qualified healthcare provider resects the diaphragm and repairs it using simple primary sutures to address the presence of diseased tissue.
6. A patient undergoes a surgical procedure in which the provider removes diseased tissue from the diaphragm and performs a repair using simple primary sutures.
7. A healthcare provider performs a resection and repair of the diaphragm, excising diseased tissue and using simple primary sutures for the repair.
8. During surgery, the provider removes diseased tissue from the diaphragm and performs a repair using simple primary sutures to restore its functionality.
9. A qualified healthcare provider performs a surgical procedure to resect the diaphragm and repair it using simple primary sutures to address the presence of diseased tissue.
10. A patient undergoes a procedure in which the provider removes diseased tissue from the diaphragm and repairs it using simple primary sutures to restore its integrity.