# Vaginal Fistula Repair



## Lanissa (May 1, 2019)

Good Morning - 
I'm fairly new to Urology and I have an op report that has me a little confused.
The primary procedure is 57295 Revision of Vaginal Graft.  However he also repaired/closed 3 vaginal mucosal fistulous tracts and that is where I'm getting hung up.
When asked if these might be considered rectovaginal, urethrovaginal, vesicovaginal  the doctor replied "none of the above".  I can't seem to locate anything else that might qualify.

Are the fistula repairs included in the revision? or Do I just need to add a 22 to the 57295 and move on?  
Any suggestions greatly appreciated - thank you! 

_The fistulous tract from where the mesh was protruding was evaluated. The edges of this fistula were freshened with Metzenbaum scissors. The fresh mucosal edges were then sutured together primarily with 2-0 Vicryl suture. Good closure of the fistulous tract was identified. The two midline fistulous from where the mesh previously extruded were identified. These fistulous tracts were mucosalized. The mucosa of the fistulous tract was removed and the new mucosal raw edges were sutured together using running 2-0 Vicryl sutures. This was performed for each of the identified midline fistulous tracts. Good coaptation of the vaginal mucosa was achieved. A good closure of the fistula tracts were identified. _


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## meghanhannus (May 1, 2019)

Hello Lanissa,

Since the provider confirmed that the vaginal fistula is not a rectovaginal, vesicovaginal or urethrovaginal I would consider this included within CPT 57295. I would not use modifier 22 as the documentation does not support any additional time etc.. to support the use of that modifier.


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