E. maria Posted Thu 16th of April, 2015 16:50:54 PM
Patient with chronic colovesical fistula underwent a Hartmann's procedure CPT 44143 and primary repair of bladder defect. I tried CPT code 51880 for the bladder repair but my system tells me diagnosis code 596.1 does not support this CPT code. Is there a better CPT code for the closure of the bladder?
SuperCoder Answered Fri 17th of April, 2015 00:59:41 AM
Use CPT code 44661 with ICD-9 596.1 only for Chronic Colovesical Fistula repair with intestine resection.
E. maria Posted Fri 17th of April, 2015 13:59:45 PM
The problem is because the fistula was so bad, Dr. performed a colectomy, partial; with end COLOSTOMY of distal segment (Hartmann type procedure) CPT 44661 does not include a colostomy. The bladder defect was about 4 cm in lenght. It was closed primarily using interrupted 2-0 Vicryl suture.
SuperCoder Answered Mon 20th of April, 2015 00:45:04 AM
Use CPT code 44320 ( Colostomy or skin level cecostomy) with CPT code 44661. The primary diagnosis code associated with 44661 is 596.1 (Intestinovesical fistula). Report ICD-9 code 562.11 (Diverticulitis of colon [without mention of hemorrhage]) as the secondary diagnosis.