Urology Coding Alert

Question: Is there a CPT code for a "vesico colonic fistula?" My urologist has indicated this to be the procedure performed, but I can't find a code with a description remotely close to his.

New Jersey Subscriber

Answer: Your urologist may not have given you much to go on in his description of the procedure, but one word, "colonic," can at least send you in the right direction: to the Digestive System section of CPT.

Your urologist is documenting a communication or fistula, between the colon and the bladder. This complication can arise from diverticulitis or possibly even cancer of the colon. Use ICD-9 code 596.1 (Intestinovesical fistula), and if the urologist documented performing a surgical repair of the fistula, report either 44660 (Closure of enterovesical fistula; without intestinal or bladder resection) or 44661 ( with intestine and/or bladder resection) depending on what the urologist dictates in the operative report.