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to code or not to code

  1. #1
    Question to code or not to code
    Medical Coding Books
    I am confused on how to code this. A patient was undergoing a placement of a sling. She also had a cystoscopy. I originally ruled out 57287. However I am stuck with 57288 and 52001, and 51992 and 52001, I read the rules and it stated not to report the 52001 in conjunction with 57288? Now it did not state if it was laparoscopic or not so I could rule out 51992, and code it as 57288 alone since I should not report 52001? I my be thinking too much on this one, but my mind is telling me to code 57288 alone. Can anyone help?

  2. #2
    Smile Pvs
    Most "typical" pubovaginal slings are 57288 unless documentation shows that it was done by alternative approach (laparoscopic). Now the question is the cystoscopy-52000 is likely what the physician did to inspect the bladder to make sure the bladder is patent and in good position with good support. 52001 (to the best of my memory without a CPT book in front of me) is Cystoscopy with irrigation of clots. While the patient could have had some bloody urine as a result of surgery, the purpose of the cystoscopy is to check the surgeon's work, not a diagnostic tool, not for a medical purpose. This means that unless there was a medical reason for the cystoscopy, it should be considered part of the procedure. Cystoscopy is not currently bundled with PVS so if there is a medical purpose behind the procedure, by all means bill for services rendered. I'm sure there are people who disagree however if this is something you do on every patient, every time-you could have a difficult time proving medical necessity. Another point to consider, most surgeons will do a cystoscopy prior to the PVS-could be difficult to ask for the insurance to pay for another so soon without a medical reason!
    Hope this helps!
    Ann Linton, CPC, CEMC, CUC

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