Urology Coding Alert

Reader Question:

45560 or 57250 Depends on Procedure Specifics

Question: I have a physician who performed a colpocleisis and then a TVT sling. He then stated: "Once the prolapse had been imbricated we directed our attention to the perineorrhapy." The op note states an incision was made through the perineal skin and vaginal mucosa and excised. He dissected the vagina mucosa off the underlying muscles and facia with one finger in the rectum to make sure he did not compromise the rectal mucosa. He placed two sutures through the transverse perineal muscles and distal levators to reapproximate these in the midline and re-create a normal levator plate angle and close the genital hiatus. He usedone suture for this. The vaginal mucosa was then trimmed and then he completed the procedure with a TVT sling placement. I am leaning toward 45560 as opposed to 57250 for the rectocele repair. Which code is the best to use?Massachusetts SubscriberAnswer: For this procedure, [...]
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