# Open Sling CPT Code?



## brittburkhardt (Jun 6, 2018)

I just finished a practice exam from AAPC, and I’d love more clarification on the correct answer. 

67 year old female having urinary incontinence with intrinsic sphincter deficiency is having a cystoscopy performed with a placement of sling. An incision was made over the mid urethra dissected laterally to urethropelvic ligament. Cystoscopy revealed no penetration of the bladder. The edges of the sling were weaves around the junction of the urethra and brought up to the suprapubic incision. A hemostat was then placed between sling and the urethra, ensuring no tension. 

No where in the description does it say “open sling”. I’m not sure what it means by open, why is the correct code 57288?


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## CodingKing (Jun 7, 2018)

brittburkhardt said:


> I just finished a practice exam from AAPC, and I’d love more clarification on the correct answer.
> 
> 67 year old female having urinary incontinence with intrinsic sphincter deficiency is having a cystoscopy performed with a placement of sling.* An incision was made over the mid urethra dissected laterally to urethropelvic ligament*. Cystoscopy revealed no penetration of the bladder. The edges of the sling were weaves around the junction of the urethra and *brought up to the suprapubic incision*. A hemostat was then placed between sling and the urethra, ensuring no tension.



I bolded the parts that indicate open. There was a Cystoscope involved but that is not inserted through an incision but direct through the urethra


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## skyyisthelimit (Jun 12, 2022)

brittburkhardt said:


> I just finished a practice exam from AAPC, and I’d love more clarification on the correct answer.
> 
> 67 year old female having urinary incontinence with intrinsic sphincter deficiency is having a cystoscopy performed with a placement of sling. An incision was made over the mid urethra dissected laterally to urethropelvic ligament. Cystoscopy revealed no penetration of the bladder. The edges of the sling were weaves around the junction of the urethra and brought up to the suprapubic incision. A hemostat was then placed between sling and the urethra, ensuring no tension.
> 
> No where in the description does it say “open sling”. I’m not sure what it means by open, why is the correct code 57288?


Keywords: ER, direct the activities, direct the activities, Emergency Department, another hour stabilizing, CPR



Rationale.

Dr. H Art performed EMS emergency care , code 99288 must be coded. This eliminates answers B and D.

Next, we need a code for the critical care (1 hour) 99291.

Finally, according to Critical care guidelines, there are services bundled into the critical care, however cardiac resuscitation  code 92950 is not bundled therefore it has to be coded separately, which eliminates answer C.


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