How To Use CPT Code 39561

CPT 39561 describes a complex repair procedure on the diaphragm, involving the resection of diseased tissue and the use of a prosthetic material or local muscle flap for repair. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 39561?

CPT 39561 is a code used to describe a complex repair procedure on the diaphragm. This procedure involves the resection of diseased tissue and the use of a prosthetic material or local muscle flap for repair. It is commonly performed to excise diseased tissue that has spread from a tumor into the diaphragm.

2. Official Description

The official description of CPT code 39561 is a resection of the diaphragm with complex repair, which may include the use of prosthetic material or a local muscle flap. This procedure is typically performed to correct defects and connect the remaining diaphragm to the costal margin.

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. An incision is made in the chest or abdomen to provide optimal exposure to the diseased area.
3. The provider may divide and move structures as necessary to access the area.
4. Retractors are placed to allow for better visualization and access to the space.
5. The diseased tissue is excised, often using electrocautery.
6. The provider then performs a complex repair, which may involve debriding the wound, excising scar tissue, and placing stents or other preparations before closure.
7. A prosthetic material or local muscle flap may be used to repair the diaphragm.
8. The provider closes the chest incision in layers.

4. Qualifying circumstances

CPT 39561 is typically performed on patients who require a complex repair of the diaphragm due to the spread of diseased tissue from a tumor. The procedure may involve the use of a prosthetic material or local muscle flap for repair. It is important to note that this procedure should only be performed by a qualified healthcare professional with the necessary expertise and training.

5. When to use CPT code 39561

CPT code 39561 should be used when a complex repair of the diaphragm is performed, involving the resection of diseased tissue and the use of a prosthetic material or local muscle flap. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT code 39561, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for a complex repair of the diaphragm
• Details of the procedure performed, including the use of a prosthetic material or local muscle flap
• Date and duration of the procedure
• Any additional work performed, such as debridement or excision of scar tissue
• Details of the closure technique used
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 39561, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The use of a prosthetic material or local muscle flap should be documented and supported by the medical record. It is also important to follow any additional guidelines or requirements set forth by the payer or coding guidelines.

8. Historical information

CPT code 39561 was added to the Current Procedural Terminology system on January 1, 2000. It has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A surgeon performs a complex repair of the diaphragm using a prosthetic material to correct a defect caused by the spread of a tumor.
2. A patient undergoes a complex repair of the diaphragm with a local muscle flap to repair a defect resulting from trauma.
3. A healthcare professional performs a complex repair of the diaphragm using a prosthetic material to correct a congenital defect.
4. A surgeon performs a complex repair of the diaphragm with extensive dissection to remove diseased tissue and repair a defect caused by a tumor.
5. A patient undergoes a complex repair of the diaphragm with a local muscle flap to repair a defect resulting from a previous surgical procedure.
6. A healthcare professional performs a complex repair of the diaphragm using a prosthetic material to correct a defect caused by an infection.
7. A surgeon performs a complex repair of the diaphragm with extensive dissection to remove diseased tissue and repair a defect caused by trauma.
8. A patient undergoes a complex repair of the diaphragm using a prosthetic material to correct a defect resulting from a previous surgical procedure.
9. A healthcare professional performs a complex repair of the diaphragm with a local muscle flap to repair a defect caused by an infection.
10. A surgeon performs a complex repair of the diaphragm with extensive dissection to remove diseased tissue and repair a defect caused by a congenital abnormality.