# tot coding



## MarineMom1 (Nov 18, 2010)

Hi,
Can someone tell me all the coding for a tot?  
tot- 57288 and insertion of mesh 57267?  Is the mesh insertion code always filed with the tot 57288?
Thanks in advance for your help!


----------



## bonzaibex (Nov 18, 2010)

Here's what I find on my online coding site regarding the 57267:

Tips
Report +57267 in addition to the primary procedure for every site needing insertion of mesh or other prosthesis. You can report the addition of mesh using +57267 with the following primary codes: 45560, 57250, 57260, 57265, and 57285. Also remember that because the code is an add-on code, do not append modifier 51 (Multiple procedures) to +57267 or reduce the fee you're charging for the procedure.

According to the above, it looks like the answer is no to both your questions.  I'd be very interested if anyone else has conflicting information.

Becky, CPC


----------



## preserene (Nov 18, 2010)

well , Becky all your inforamtions are correct and no denial.

But I basically/ procedurally, feel that the particular procedure  TOT- whether the time honored nonstandardized, or Standardized TOT (tension free sling /vaginal tape procedures or the recent most welcoming newer procedure- TOT SLINGPprocedure- the message is - they use the tape for the sling (MESH TAPE). By meaning, tape - it means, it could be fascia from patient, cadevor or dermis from human /animals SYNTHETICS etc .
Only in their APPROACH, USING SPACE, TIME CONSUMPTION, ANESTHESIA MODULATION , they differ.
However the tape is the MESH- what the CPT description says as fascia, or synthetic etc , and it is the important component of the TOT procedure. SO, THE MESH INSERTION IS AN INTEGRAL PART OF THE TOT PROCEDURE AND WE CANNOT CORROLATE THE CODE 57267 ON TO IT.
57267 IS FOR another procedure for purpose of Pelvic Floor defects - anterior ,posterior vaginocele, rectocele and repair of the pelvic floor procedures with insertion of MESH. For eg, colporrhaphy or while doing Pelvic Floor Repair procedures, if they insert a Mesh as an reinforcing or additional support, this is added as add on code, because the original procedure does not have it as a component.
 I hope I make some sense, a procedural sense!
So as to my knowledge the mesh introduction is an integral component of the TOT procedure.
The payer's View  is another story.
Thank you


----------

