Reader Questions:
Knockout Coding for Fistulagram
Published on Wed Apr 06, 2005
Question: I need a code for fistulagram. The patient had a superficial skin-to-skin penile fistula. Dye was injected and exited about 4 cm from the injection site just superficial to the skin.
Virginia Subscriber Answer: Report 20501 (Injection of sinus tract; diagnostic [sonogram]) for the performance of the fistulogram. If a radiological study was performed, report 76080 (Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation).
Don't miss: Medicare splits 76080 into professional and technical components for reimbursement. If the urologist performed this procedure in a facility outside of the office, you cannot claim the technical component of 76080. Append modifier -26 (Professional component) to 76080 performed in another facility to claim only the professional component.
Link the procedures to ICD-9 diagnosis code 686.9 (Unspecified local infection of skin and subcutaneous tissue; fistula of skin NOS) or 607.89 (Other specified disorder of penis), or to both.
