Urology Coding Alert

Question: We recently harvested graft tissue for a sling operation and are uncertain how to code the procedure. The last time we billed for harvested graft tissue for the same operation we were not reimbursed for the procedure. What are the coding rules for billing separately for graft tissue and sling operations? Colorado Subscriber Answer: Coding for procuring graft tissue for open sling procedures is always difficult. Thanks to the AUA terminology committee and the American College of Obstetrics and Gynecology, we can now bill for harvesting the graft.

Sling procedure codes do not include a specific description of harvesting graft material. If you obtain the tissue from the abdominal rectus fascia, which might have been the case with your procedure, you can now bill for it.

The following codes are billable: 20920 Fascia lata graft; by stripper 20922 by incision and area exposure 20926 Tissue grafts, other (e.g., paratenon, fat, dermis). You will receive full payment for these codes when billed with your sling procedure code. An example of a coding scenario: 57288 Sling operation for stress incontinence (e.g., fascia or synthetic) 20926 (no modifiers are needed because this code is modifier -51 exempt).