Urology Coding Alert

Question: What is the appropriate code to report a laparoscopic sigmoid colectomy with repair of a colovesical fistula?

North Carolina Subscriber

Answer: You should report code 44204 (Laparoscopy, surgical; colectomy, partial, with anastomosis) for the colectomy. This part of the surgery is usually performed by a general surgeon.

For the urologist, the closure of the fistula during the same session would be reported separately with code 51999 (Unlisted laparoscopy procedure, bladder). Each surgeon would bill separate claims for this clinical scenario documenting the work each performed.

Remember: When you report an unlisted code to describe a procedure or service, be sure to include supporting documentation (such as the operative report) with the claim to provide the insurer with an adequate description of the nature, extent, and need for the procedure as well as the time, effort, and equipment necessary to provide the service. Benchmark or reference the laparoscopic code to CPT® code 44661 (Closure of enterovesical fistula; with intestinal and/or bladder resection). A cover letter including this information may also be necessary so that the payer fully understands the service your physician provided.