Urology Coding Alert

Reader Question:

Stamey Suture Excision

Question: How should we code the excision of a Stamey suture? The stitch was put in many years ago by a different physician, and the patient now has pain. The urologist did an exploration of the suprapubic incision and excision of left Stamey suture.

Maine Subscriber 
 
Answer: The Stamey procedure is rarely performed. A Stamey suture holds a piece of nonreactive material supporting the anterior vaginal wall like a sling. If releasing the stitch through a suprapubic incision, use 10120* (incision and removal of foreign body, subcutaneous tissues; simple), unless complicated, in which case use 10121 (... complicated). If released transvaginally, use 57287 (removal or revision of sling for stress incontinence [e.g., fascia or synthetic]). For either procedure, the patient may have some stress incontinence after the release of the stitch, but there may be enough fibrosis to hold up the urethra and preserve continence.
 
There is no extra fee for the exploration, as you simply go in through the pre-existing incision, and the exploration is an integral part of your procedure.