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Urology Coding Alert

Don't Miss Out on $260 in Additional Pay

Code for mesh insertion with some prolapse procedures. During some prolapse repair procedures, the urologist will add mesh to strengthen the repair. In some cases, you can report the mesh insertion separately, but in others you cannot. Knowing which procedures allow the additional mesh procedure coding can bring in additional reimbursement for each repair procedure as long as the physician documented medical necessity for the mesh. When allowed, you should report the mesh insertion using +57267 (Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site [anterior, posterior compartment], vaginal approach [List separately in  additional to code for primary procedure]), says Nicole Martin, CPC, owner of Innovative Coding Analysis in Coplay, Pa. This add-on code requires no modifier or fee reduction. CPT 2009 Increased Your Opportunity Add-on code +57267 didn't change in 2009, but the parenthetical note following the descriptor did. It now states, "Use 57267 [...]