Urology Coding Alert

Question: The urologist removed eroded bladder mesh and helical staples from a patient's bladder from a 2001 lap urethropexy by a gynecology surgeon through lower midline incision (intravesical and extravesical). He also placed a pelvic drain and three-way Foley (no SP tube). How should I code this?

Maryland Subscriber

Answer: Report 27087 (Removal of foreign body, pelvis or hip; deep [subfascial or intramuscular]) for the removal of the pelvic foreign bodies, the staples and mesh. Next you should report 51040 (Cystostomy, cystotomy with drainage) for the suprapubic cystotomy and drainage.

You use 27087 from the orthopedic section of the CPT manual for the extravesical (pelvic) removal of the foreign bodies. The closest ICD-9 diagnostic code for you to use would be 996.76 (Other complications; due to genitourinary device, implant, and graft).