Urology Coding Alert
Don't Code Sling Removal Along with Replacement
Question: The urologist performed urethrolysis with excision of an eroded sling and a new transobutator sling placement. Would this just be one code: 57287? Or, would it be 57288, 53500, and 57296?
California Subscriber
Answer: For this case, first, report 53500 (Urethrolysis, transvaginal, secondary, open, including cystourethroscopy [eg, postsurgical obstruction, scarring]) for the urethrolysis. Append modifier 52 (Reduced services) if your urologist did not perform a cystourethroscopy.
Next, report 57288 (Sling operation for stress incontinence [eg, fascia or synthetic]) for the new sling replacement.
Important: The actual removal would not be billable when you are replacing a new device (the sling). This scenario is similar to when your urologist replaces a stent. You should just bill for the replacement not for both the removal and replacement.
Reporting 57296 (Revision [including removal] of prosthetic vaginal graft; open abdominal approach) is incorrect coding in this scenario. Code 57296 is an open, abdominal approach used for the removal of a vaginal graft/mesh, not removal of a vaginal sling.
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