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Urology Coding Alert

Reader Questions:

Rely on Unlisted-Procedure Code for Burch Takedown

Published on Wed Apr 06, 2005

Question: What is the proper code for Burch takedown or retropubic lysis of adhesions and suture removal?

South Carolina Subscriber Answer:  Report 53899 (Unlisted procedure, urinary system). There is no CPT code for a retropubic urethrolysis or takedown of a previously performed Burch colposuspension (bladder neck suspension) or other cystourethropexy to treat stress urinary incontinence.
 
Experts previously considered 57287-52 (Removal or revision of sling for stress incontinence [e.g., fascia or synthetic]; reduced services) to be the closest code for the urethrolysis. However, CPT now instructs coders to use 53899, the unlisted-procedure code, for the supra/retropubic lysis of the urethra.
 
Many 2005 CPT manuals include this note under 53500 (Urethrolysis, transvaginal, secondary, open, including cystourethroscopy [e.g., postsurgical obstruction, scarring]): "To report urethrolysis by retropubic approach, use 53899." If the urethrolysis is performed vaginally, use 53500.
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