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Urology/Vesicocutaneous Fistula

Cherie Posted Fri 19th of September, 2014 09:04:02 AM

Hi,
I am looking for a cpt for the closure of a vesicocutaneous fistula.
Any help would be appreciated.

SuperCoder Answered Mon 22nd of September, 2014 09:00:53 AM

Thanks for your question.

With limited information provided. Most vesicocutaneous fistulae result from a failure of a suprapubic tract to close completely after the removal of a temporary suprapubic cystostomy tube, i.e. CPT 51880 can be use for closure of this type of fistula.

Hope this helps.

Cherie Posted Fri 26th of September, 2014 07:23:44 AM

The pt had a Mace procedure in the past. He made a low midline incision Scored around the fistula itself, above and below the fistula. I went through the skin and subcutaneous tissue, then dissected out the fistula tract. I then opened the rectus fascia around the fistulous tract. I identified the bladder. I dissected it free of the rectus muscle and the rectus fascia, and just now had a fistula tract. At this point the fistula was clearly going into the bladder. I opened the fistula tract and got fluid coming out of the bladder. I then removed the entire vesicocutaneous fistula w/ the skin, tract and piece of the bladder that was affected. This was passed off the table as a specimen.
Then the doctor closed.

Cherie Posted Wed 01st of October, 2014 06:19:39 AM

Hello, have you had a chance to review yet? Thanks

SuperCoder Answered Wed 08th of October, 2014 06:54:19 AM

Thanks for your query.

After reviewing provided information and considering vesicocutaneous fistula is the result of previous cystostomy tube placement and not related to MACE procedure or due to other pathological manifestation, you can report 51880 in this case.

Most vesicocutaneous fistulae result from a failure of a suprapubic tract to close completely after the removal of a temporary suprapubic cystostomy tube. This means you should use 51880 because it is the most accurate code for closure of this type of fistula.

As with most excisions and closures of fistulae, physician removes the tract, and therefore the repair of the defect becomes the primary procedure.

Hope it answers your query. If you have any additional questions, please let us know.

Regards!

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