Ob-Gyn Coding Alert

Question: Our physician states he performed a posterior colporrhaphy with enterocele repair, a cell graft hysteropexy and an Altis sling. Would I code 57288, 57250(51) and 57267(59)?

Texas Subscriber

Answer: You would code the Altis sling with 57288 (Sling operation for stress incontinence [eg, fascia or synthetic]).

But you can't report 57267 (Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site [anterior, posterior compartment], vaginal approach [List separately in addition to code for primary procedure]) for a graft used on the uterus (hysteropexy). This code is only for a vaginal wall graft.

If the op note describes that he placed it on the posterior vaginal wall, then 57267 would apply. In your question, however, you have not indicated a code for enterocele repair (57268, Repair of enterocele, vaginal approach [separate procedure]), which is not bundled with 57250 (Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy).