bundling implantation of mesh

We frequently do multiple hernia repairs in the same setting and are having trouble with the billing. The insurance companies are conveniently bundling the mesh code 49568 in with the inguinal hernia code 49505 even though I bill with the 49568 following the parent code of 49560 and with the ventral hernia dx as below. My question is whether or not it is appropriate to bill the 49568 with a modifier -59 to bypass the edit so I don't have to appeal every time... or any other suggestion?

49560 553.20
49568 553.20
49505-51 550.90

mesh

http://www.facs.org/ahp/pubs/tips/tips0208.pdf

article

Nancy, thank you. I reviewed the article and I believe it confirms that 1. I can bill for both hernias as they are separate incisions and not bundled, 2. that it is appropriate to bill the mesh with the incisional or ventral hernia. I realize that the 49568 is an add-on code and should not require a modifier but am trying to find a work around to keep the insurance from denying the code 49568 because it appears on the same claim as a inguinal or umbilical hernia; even though it is being billed appropriately with code 49560. My thought was to try mod 59 on the mesh code since it is the one being incoreectly denied.... but maybe i should try a cover letter instead? Any input?

appeal

Make sure the ICD-9 codes appropriately link to type of hernia