Urology Coding Alert

Question: Im trying to code the takedown of a Burch colposuspension. Can you assist me?

Trenda Lee,
University Hospital, Columbia, Mo.

Answer: The Burch procedure is a retropubic suspension supporting the urethra by elevating the vaginal fascia to the urethra. Nonabsorbable sutures are placed through Coopers ligament and through pelvic fascia at the ureterovesical junction on either side to provide support to the bladder and urethra. Takedown of a Burch colposuspension would most likely be performed in conjunction with further surgery for correction of female urinary incontinence or other repair of the urethra in which case the takedown would be considered part of the more definitive procedure and would not be separately coded.

The correct code for the procedure you describe could only be determined after review of the operative report. There are various examples of codes that could be used, including the incontinence repair codes, such as 53430 (urethroplasty, reconstruction of female urethra), 53445 (operation for correction of urinary incontinence with placement of inflatable urethral or bladder neck sphincter, including placement of pump and/or reservoir), 57284 (paravaginal defect repair [including repair of cystocele, stress urinary incontinence, and/or incomplete vaginal prolapse]), and 57288 (sling operation for stress incontinence [eg, fascia or synthetic]).