# Uteroperitoneal fistula repair



## kcurry1 (Jul 28, 2011)

Does any one know a procedure code for uteroperitoneal repair.  Procedure was performed through laparotomy.  Thanks


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## preserene (Jul 28, 2011)

it is a very rare form of fistula of the uterus and recently identified and as such we do not have a code with specific proximity 
We do not have any CPT code  matching it. The point is, either one from peritoneum section or uterine section we can select, if we have one. We do not have any matching nearer on any of these anatomical section.
Towards the uterine side too, we do not have one matching it. 
But, anyway, there is a *uterine defect which is the main stay of the procedure*. Instead of coupling the fistula with other anotomical fistula like vesicle, urethaletc, the best is to concentrate on the main intension and main saty of the procedure to have an ultimate closure effect of the uterine defect. Uterine closure due to the fistula, is the main procedure rather than on the peritoneum. Due to the defect (path/track) in the uterus, th eperitoneum gets in to the tract.
So it is logical to select one from the uterine section. The closure of the uterine fistula -  Uterine repair-  is making suture repair of the uterus. 
Suture of the uterus is - *hysterorrhaphy*- * 58520*- could be the nearer one to the  procedural and anatomical family of the code closer/proximal.
If is it due to anomaly hysteroplasy 58540 could be suggested. 

We do not have an unlisted repair code for the uterus. 
Any other possible or feasible suggestion with more proximity?
It is a good topic for search. I know someone would say it is a guess work. 
When there is no way, then we go for finding a way !!?

Well we can give ICD-9 CM code to support 619.8 and a detailed report the whole situation an dthe nonavailabilityof specific CPtcode an dthe main theme an dsaty of the procedure and stuff like that from the Physician.
Thanks for tuning in and patiently listening!!


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## kcurry1 (Jul 28, 2011)

*uteroperitoneal fistula*

I am dealing with a Medicaid patient so I can not use any unlisted procedure per Georgia Medicaid.  I like the hysterorrhaphy- 58520 procedure.  I looked at this code but I couldn't get past the rupture.  Pt. did not have a rupture but she did have a fistula and physician had to layer close a portion of the uterus.  I will try this one.  Thanks


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## preserene (Jul 28, 2011)

The code was intended for rupture, though, a like situation wherein there is a hole/fsitula which could be akin to the codition rupture, the procedure of the repair, however,almost the same. Yes I suggested just for a trial to code, with the view we do find none. Fistula origin we do not know-aquired (most likely if she had asurgery on uterus before) or anamaly. 
(based on the  groups-like CMS 's  DCG/ HCC models).
Thank you.


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