Wiki Vaginal Mesh Excision

[rachell1976]

How to code?

PROCEDURE: The patient was brought to the operating room arena and
given general anesthesia. She had a complete vaginal prep performed,
and her peritoneum was prepped and draped as well. A weighted speculum
was placed. Her labia were retracted with 2-0 silk suture.

Cystoscopic examination was performed. Bladder failed to demonstrate
any areas of erosion, stones, foreign bodies, or tumors. I then used a
Metzenbaum scissors to cut along the midline of the anterior vaginal
wall. The mesh was tightly intertwined with the anterior vaginal wall,
and I essentially had to pick at it with a forceps. With persistence,
palpable and visible mesh was excised along the exposed area of her
previous midline incision along the anterior vaginal wall. After
removing the exposed mesh, I performed another cystoscopic examination.
The bladder was free of any trauma or perforations. I elected not to
leave a Foley catheter. A vaginal packing was placed. The patient
tolerated the procedure well and was taken to recovery in stable
condition.

 

[daniel]

How to code?

PROCEDURE: The patient was brought to the operating room arena and
given general anesthesia. She had a complete vaginal prep performed,
and her peritoneum was prepped and draped as well. A weighted speculum
was placed. Her labia were retracted with 2-0 silk suture.

Cystoscopic examination was performed. Bladder failed to demonstrate
any areas of erosion, stones, foreign bodies, or tumors. I then used a
Metzenbaum scissors to cut along the midline of the anterior vaginal
wall. The mesh was tightly intertwined with the anterior vaginal wall,
and I essentially had to pick at it with a forceps. With persistence,
palpable and visible mesh was excised along the exposed area of her
previous midline incision along the anterior vaginal wall. After
removing the exposed mesh, I performed another cystoscopic examination.
The bladder was free of any trauma or perforations. I elected not to
leave a Foley catheter. A vaginal packing was placed. The patient
tolerated the procedure well and was taken to recovery in stable
condition.

57295 vs 57287. based on this it's 57295. But my experience leads me to ask is this really a mesh or sling removal? They used this term interchangably.