Urology Coding Alert

Question: The urologist performed a transvaginal closure of a urethrovaginal fistula with harvest of a Martius fat pad graft (bulbocavernosus transplant). Can you advise me as to the correct CPT^® code(s)?

California Subscriber

Answer: Submit 57311 (Closure of urethrovaginal fistula; with bulbocavernosus transplant) for the fistula closure. The bulbocavernosus transplant is a fat pad graft. If the surgeon uses the Martius transplanted fat pad repair alone or with another procedure as in the closure of a vesicovaginal fistula repair (57320, Closure of vesicovaginal fistula; vaginal approach), code 57311 in addition to the other procedure and append modifier 52 (Reduced services) for just the transplanted fat graft.