Urology Coding Alert
Coding for Laparoscopic Cystotomy Repair
Question: I’m coding for the robotic assisted removal of a vaginal mesh and closure of an inadvertent cystotomy. The surgeon assigned diagnoses T83.498A and N21.0. What are the correct surgical codes?
Oklahoma Subscriber
Answer: CPT® 2016 does not include a code for a laparoscopic cystotomy repair. That means you need to bill the unlisted code 51999 (Unlisted laparoscopic procedure, bladder).
Tip: Benchmark the work and pricing to 51860 (Cystorrhaphy, suture of bladder wound, injury or rupture; simple) for a simple procedure or 51865 (... complicated) if the procedure can be considered complicated. Report 57426 (Revision [including removal] of prosthetic vaginal graft, laparoscopic approach) for the removal of the vaginal mesh.
Apply ICD-10 diagnostic codes S37.23XA (Laceration of bladder, initial encounter) and N99.71 (Accidental puncture and laceration of a genitourinary system organ or structure during a genitourinary system procedure) for the closure of the cystotomy. Also include T83.498A (Other mechanical complication of other prosthetic devices, implants and grafts of genital tract, initial encounter) for the removal of the vaginal mesh. ICD-10 code N21.0 (Calculus in bladder) would be inappropriate in this clinical scenario.
Related Articles
Urology Coding Alert
- ICD-10 Update:
Prepare Now for What Diagnosis Changes Might Be Coming in October
Start by exploring catheter, genitourinary hemorrhage, and diagnostic imaging updates. October will bring the first [...] - Coding Basics:
Be Confident In Distinguishing Modifier 57 from 25
The timing plays an important part. Adding modifiers to your claims can be a simple [...] - Clip 'n Save:
Let These Lists Keep Your 25 and 57 Claims Straight
Check these points to choose correctly. It’s not unusual for coders – or providers – [...] - Reader Question:
Diagnosis D49.4 Can Represent a Bladder Lesion
Question: A patient had a cystoscopy during the post-operative global period of a laser enucleation of [...] - Reader Question:
Submit Multiple Codes for Complicated PCNL
Question: The surgeon did a cystoscopy and retrograde pyelogram to aid in renal access, a percutaneous [...] - Reader Question:
Steer Clear of 'Open' Codes for Laparoscopic Procedures
Question: Our coders are under the impression that we cannot use “open” surgery codes for robotic [...] - Reader Question:
Yes, Partial and Radical Nephrectomies Might Be Billable Together
Question: I’m coding for a case where a robotic partial nephrectomy was converted to a radical [...] - Reader Question:
Turn to N31.8 for Neurogenic Bladder Diagnosis
Question: The urologist performed an open suprapubic tube placement and an open retropubic bladder neck closure. [...] - Reader Question:
Only Include N13.2 When Calculus Obstruction Is Present
Question: A patient was diagnosed with a renal stone and hydronephrosis. Can we code N20.0 for [...] - Reader Question:
Remember Modifier 51 When Reporting 50220 With 50380
Question: Our surgeon performed a total nephrectomy and then a reimplantation of the same kidney, a [...] - Reader Question:
Here's Your Primer for Avoiding 'Incorrect Modifier' Denials
Question: Due to staff reduction, I have been recruited into doing some coding. I’ve been able [...] - You Be the Coder:
Coding for Laparoscopic Cystotomy Repair
Question: I’m coding for the robotic assisted removal of a vaginal mesh and closure of an [...]
