Urology Coding Alert

Question: When the urologist performs 57282 and uses mesh, is the mesh included in the main code? Or is there a separate code I should report for the mesh? I see +57267 but am not sure if it applies in these cases.

Delaware Subscriber

Answer: This is a trickier question than appears on the surface. No coding edits are in place to prevent both services together, which leads coders to think it’s acceptable. CPT^® coding guidelines give a different viewpoint, however.

When you look up add-on code +57267 (Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (List separately in addition to code for primary procedure)), this is an add on code as indicated by the + sign before the code. The guidelines list specific primary procedures you can only report with it. Code 57282 (Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)) is not part of the list of allowable primary procedures, so you should not report the two codes together. Only report 57282.