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CPT code for exloration of fistula

Janie751

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Can anyone help me with the correct CPT code to use for transperineal exploration of a rectourethral fistula?

The other procedures are:
Cystourethroscopy (I am using 52000) and Urethroplasty (53410) with a diagnosis of 599.1.

There was another surgeon who did a procedure after this and is using 45505.

I have just started coding surgeries for a urologist, so I would appreciate any help, including any resources you might suggest that would be helpful.
 
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Janie751

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Yes, he does repair the fistula. I could not find the code 46470, could this be a deleted code? Thank you for responding.
 

Janie751

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I had to look up "imperforate" to see what it means. This does not apply in this case because it said having no opening or lacking the usual and normal opening. I have been looking at code 53415 and thinking it might be better than using 53410. After looking at detailed information about this code, I am wondering if it might include the exploration. Thank you again for responding and I welcome any other suggestions you might have.
 
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22 modifier

This is NOT my area of expertise, but ...
Have you considered adding the [22] modifier to 53410 (or 53415) to indicate the additional work of the exploration/repair of the fistula? You would also increase your fee. Be prepared to attached supporting documentation, and possible to appeal for additional reimbursement.
F Tessa Bartels, CPC
 

Janie751

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I did not think about using the modifier. I will do some more research and see if that might work. Thank you for taking the time to respond.
 
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