Lynn Posted Thu 11th of December, 2014 06:43:08 AM
CPT code(s) for removal of vaginal and abdominal mesh.
A lithotomy position, a thorough physical examination confirmed the location of her sling located in midurethra vaginally. Suprapubically there were just 2 puncture sites that were noted from her previous surgery, they were able to be noticed it palpated to help guide our suprapubic incision. Suprapubic incisions were made 10 centimeters long and pubic area through skin and down to the subcutaneous fascia. This was done approximately 1 centimeter above the pubic bone to allow us to locate her sling from this direction, it did take quite a bit of time, but we were able to finally find each of these arms of the sling. They were dissected down to the blunt and then dissected all the way down to the fascia bilaterally. The fascia was opened between the 2 arms of the sling to allow us to gain access to the retropubic space. This was done and dissection was carried down closed perineal membrane around the bladder. This was all done with a Foley catheter in place draining urine. We then directed our attention to the vaginal incision. An inverted U-shaped incision was created after hydrodissecting with lidocaine with epinephrine. The mesh was found in its normal anatomic location circumscribed and divided in the center and each arm was dissected up towards the retropubic space with a hand in the abdomen and hand in the pelvis there were a centimeter of embedded mesh in the perineal membrane. This was dissected out very carefully, taking care not to injure any vessels or the bladder. This was carried out in both directions and the mesh was able to be removed from both sides intact without dividing it.
SuperCoder Answered Fri 12th of December, 2014 07:30:53 AM
Code 57827 best matches the above description.
Code 57827 represents 'Removal or revision of sling for stress incontinence (eg, fascia or synthetic)'.