Korbc
Expert
Hey guys,
I can't find much info regarding this kind of fistula, and my doctor has submitted the following op note with 56620 but not sure if that is entirely appropriate, he does excise tissue and 51900 doesn't seem appropriate at all. Everything i look at guides me to a recto vaginal fistula or urethrovaginal fistula basically. I'm trying to picture this fistula as it seems more like a defect or hole in the vulva that just extends slightly to the vagina. It seems like this code would be appropriate, was wondering if anyone could give some more insight? Thank you so much
Indications: Perineal vagina fistula post partum
Description of Procedure: Patient was brought the operating placed in dorsolithotomy position prepped and draped in usual manner after monitored anesthesia care was initiated. A perineal vaginal fistula was identified. The area is infiltrated with half percent Marcaine with epinephrine. A tape was placed through the fistula to clearly identify it. Using a scalpel the entire fistulous tract was excised. Several 2-0 Vicryl deep sutures were placed to close dead space. The skin was then closed in the manner of NP's Demeter 3-0 Vicryl suture.
Complications: none
Operative Findings: Perineal vaginal fistula that extended into the vagina about a centimeter.
The following image is from a previous apt she had and not part of the official op note
I can't find much info regarding this kind of fistula, and my doctor has submitted the following op note with 56620 but not sure if that is entirely appropriate, he does excise tissue and 51900 doesn't seem appropriate at all. Everything i look at guides me to a recto vaginal fistula or urethrovaginal fistula basically. I'm trying to picture this fistula as it seems more like a defect or hole in the vulva that just extends slightly to the vagina. It seems like this code would be appropriate, was wondering if anyone could give some more insight? Thank you so much
Indications: Perineal vagina fistula post partum
Description of Procedure: Patient was brought the operating placed in dorsolithotomy position prepped and draped in usual manner after monitored anesthesia care was initiated. A perineal vaginal fistula was identified. The area is infiltrated with half percent Marcaine with epinephrine. A tape was placed through the fistula to clearly identify it. Using a scalpel the entire fistulous tract was excised. Several 2-0 Vicryl deep sutures were placed to close dead space. The skin was then closed in the manner of NP's Demeter 3-0 Vicryl suture.
Complications: none
Operative Findings: Perineal vaginal fistula that extended into the vagina about a centimeter.
The following image is from a previous apt she had and not part of the official op note
