Ob-Gyn Coding Alert

Question: How should I code a Burch takedown?

Michigan Subscriber

Answer: Your ob-gyn likely did a Burch colposuspension procedure originally (51840, Anterior vesicourethropexy, or urethropexy [e.g., Marshall-Marchetti-Krantz, Burch]; simple, if billed by itself).  

Because no code exists for removing the sutures afterward, you would have to code the takedown as 58999 (Unlisted procedure, female genital system [nonobstetrical]).

There is a code for the takedown of a sling procedure (that is, the procedure would have originally been coded as 57288), but this procedure is different from a Burch. Therefore, you cannot use 57287 (Removal or revision of sling for stress incontinence [e.g., fascia or synthetic]). 

In some cases, however, the operative note will describe urethrolysis, 53500 (Urethrolysis, transvaginal, secondary, open, including cystourethroscopy [e.g., postsurgical obstruction, scarring]), which includes cystourethroscopy. Ask your physician if this code is more descriptive of what he did.  If not, use the unlisted-procedure code, 58999.