Urology Coding Alert

Question: How should I code a resection of a vesicosigmoid fistula? North Carolina Subscriber Answer: Look at codes CPT 44660 (Closure of enterovesical fistula; without intestinal or bladder resection) and 44661 (...with intestine and/or bladder resection). Append ICD-9 code 596.1 (Intestinovesical fistula, passage between bladder and intestine, fistula: enterovesical, vesicocolic, vesicoenteric, and vesicorectal). When a general surgeon and urologist perform these two procedures together at the same session, bill as co-surgeons with modifier 62 (Two surgeons) in one of these ways: • 44660-62 for the general surgeon and 44660-62 for the urologist, or • 44661-62 for the general surgeon and 44661-62 for the urologist. Documentation should include a detailed operative report for each surgeon and what part of the procedure each performed. Also include a cover letter from each physician explaining in layman's terms what each performed and why. The general surgeon and urologist will split an increased global fee of [...]