Ob-Gyn Coding Alert

Reader Questions:

Should You Report Graft and Sling?

Question: I need a code for a BioArc graft. I know to use the mesh code 57267 for CPT codes 45560, 57240-57265, but is there a code for the BioArc graft for a sling procedure (57288)?

Nevada Subscriber

Answer: No, you should report only the sling procedure (57288, Sling operation for stress incontinence [e.g., fascia or synthetic]). Rationale: The sling procedure code includes the graft for the sling, so you should not bill the graft separately.

Keep in mind: Code +57267 (Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site [anterior, posterior compartment], vaginal approach [list separately in addition to code for primary procedure]) is for putting in an additional graft/mesh when repairing the vaginal walls. Because this procedure is not an integral part of the vaginal wall repair, you can separately bill it.

-- The answers for Reader Questions and You Be the Coder were provided by Melanie Witt, RN, CPC-OGS, MA, an ob-gyn coding expert based in Guadalupita, N.M.