Urology Coding Alert
Modifiers Won't Break the 57287and 57288 Edit Bundle
Question: Can we bill for removal of a transvaginal sling and a replacement of a transvaginal sling during the same surgical procedure? If so, under what conditions is it acceptable? New Mexico Subscriber Answer: No, you cannot bill for both a replacement and removal of a prosthetic mesh, sling, or device. According to CPT® rules of coding, the placement of a sling includes the removal of a previously placed sling. The NCCI edits do not allow billing of 57287 (Removal or revision of sling for stress incontinence [e.g., fascia or synthetic]) and 57288 (Sling operation for stress incontinence [e.g., fascia or synthetic]) together, and you cannot append a modifier to override the bundling and submit both codes. If the surgeon removes the sling and replaces it (partially or completely) during the same encounter, only report 57288. Append ICD-10 diagnoses N39.3 (Stress incontinence, [female] [male]) and the reason for the sling removal such as T83.118A (Breakdown [mechanical] of other urinary device and implants, initial encounter).
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