Wiki CPT for Excision of exposed urethral sling mesh

[kmartinez]

Looking for help for a CPT for Excision of exposed urethral sling mesh via laser destruction.

While the provider was performing cystolitholapaxy for a bladder stone he came across the mesh which "slung across from the 5 to the 7 o'clock position right at the bladder neck, probably about 1 cm to 1.5 cm bridge right there at the bladder neck." Provider tried using endoscopic scissors to cut the mesh but they were not strong enough and therefore used a 550 micron laser fiber to break off the mesh and then finished the cystolitholapaxy procedure.

I am not sure if CPT 57287 is appropriate as it refers to a vaginal approach and this was also done via laser.

TIA
KM

 

[thomas7331]

I would think the correct code for this would be 52310 or 52315 (for a foreign body removal). These both bundle to the cystolitholapaxy, but 52315 is allowed with a modifier which I believe would be defensible in this case since it is clearly a separate procedure from the removal of the stone, and the 'complicated' in the code description for 52315 is also supported due to the need for the use of the laser to achieve the removal.

 

[kmartinez]

Thank you for your input. I greatly appreciate the help.

KM