# Deactivating Sphincter



## vanessa01 (Feb 3, 2015)

Hi Surgeon was called Intraoperative to deactivate pts artificial urinary sphincter and place a cath- I cannot find a code for the deactivation portion any ideas?
Would this be bundled into the complex cath 51703? 
Thanks
Vanessa


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## Sharona2010 (Feb 4, 2015)

Would love to know an answer to this. I have one where the dr "cycled it"?? then deactivated it. I see nothing about deactivation-which means it's probably bundled, but not sure. Any help out there? Thanks!


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## Sharona2010 (Feb 9, 2015)

Since you haven't heard anything, my two cents would be that,  yes, the 51703 would cover the sphincter removal.


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## vanessa01 (Feb 9, 2015)

Thanks for the reply Sharona I am going to capture it with the removal code and adding modifier 52 since he did not remove it just deactivated it


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## emcee101 (Feb 9, 2015)

Vanessa, 

 I think that what Sharona was saying is that the work for deactivation the AUS is included (and justified use) of billing 51703 - difficuly foley placement, vs. 51702 - simple foley placement. 

A little reasoning: an AUS has 3 components, a cuff that goes around the urethra, a resivoir that is placed in the abdomen, and a pump that is located in the scrotum. To deactive the AUS, the patient or physician simply has to manipulate the pump in the scrotum correctly. This is done with simple palpation through the scrotal skin and does not require an incision. It usually takes only a few minutes if a doctor or patient is familiar with the operation of the device.

That said, I would not bill for the AUS removal code, even with a 52 modifier, to report that a deactivation was done since removal of an AUS requires surgery with multiple incisions. For the physician, it involves substantially more work, skill and time than what is required for deactivation. 

The only way that a separate code should be billed is if the physician had to perform a scrotal exploration in order to locate the pump, which can sometimes migrate up towards the abdomen. This case is the exception to the norm and does not happen often. 

Since there is no op-note attaced with your message, it is impossible to tell what was actually done, but I am going to assume that the deactivation was performed through palpation in order to deflate the urethral cuff, which in turn will allow the catheter to pass through the urethra without destroying the AUS cuff and possibly causing damage to the urethra itself. 

Just my two cents in the end, but hope it helps.


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## Sharona2010 (Feb 9, 2015)

Thank you!


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