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rectoprostatic fistula repair code

cstovall

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Hello,

I have been searching all over for how to code this properly. I have found 45820 - closure of a rectourethral fistula, but the description of that approach is very different than what the surgeon did.

He called it a "York-Mason repair of a rectoprostatic fistula with a right gracilis flap muscle interposition." I can find all kinds of reports online about this surgery with great descriptions and pics, but no info on how to code it.

He incised along the posterior aspect of the anus and carried it up to the coccyx. He id'd all muscles and whatnot and tagged them on his way down to the fistula. He then excised the fistula and carried on with the rest of the surgery.

I think what has me stumped is the approach he took. The articles say it is a difficult approach and the surgeon said it was a 6hr surgery.

Any help would be so much appreciated!
 
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