Ob-Gyn Coding Alert

Question: The patient presents to our ob-gyn office status post-sling operation. The ob-gyn injected the patient with 2-percent lidocaine. Then the ob-gyn incised and reclosed the sling. I asked the ob-gyn what procedure she did, and she says an ureterolysis. That seems too much to charge the patient. What should I do? Maine Subscriber Answer: Your ob-gyn cannot perform ureterolysis (such as 57287, Removal or revision of sling for stress incontinence [e.g., fascia or synthetic]) in the office setting. That is a hospital procedure.  What she did was a sling revision, but again not the procedure described nor the relative value units (RVUs) involved with 57287.   You can either go with 58999 (Unlisted procedure, female genital system [nonobstetrical]) or 57287 with modifier 52 (Reduced services) and take your chances that the insurer does not deny this code for place of service.