Urology Coding Alert

Question: My urologists are performing Da Vinci robotic laparoscopic vesicovaginal fistula repairs. How should I code these procedures?Tennessee SubscriberAnswer: First, you should report CPT 51999 (Unlisted laparoscopic procedure, bladder) for the laparoscopic fistula repair. This is a bladder procedure performed abdominally so unlisted laparoscopic bladder procedure code 51999 is most appropriate.If you are billing the service to a non-Medicare payer, you should consider also reporting S2900 (Surgical techniques requiring use of robotic surgical systems [list separately in addition to code for primary procedure]) since your urologists are using the Da Vinci system. Medicare will not reimburse for S codes. But many private payers, such as the Blues, may reimburse the physician for this code indicating his use of robotic technology.Dx help: You should assign 619.0 (Urinary-genital tract fistula female) for the fistula between bladder and vagina. A vesicovaginal fistula (619.0) is an abnormal opening between the vagina and the bladder [...]