We see these alot. There is no lap takedown for the colovaginal fistula. We bill these as unlisted lap with mod 59. You have to be careful though because alot of carriers want to bundle it. It helps if you can give 1 diagnosis for the Hartmen (diverticulitis) and another for the takedown (colovaginal fistula). If the diagnosis is the same then use lap hartmen with 22 if you can prove with the op report that the takedown added significant time, difficulty, and risk.
Also, 57300-57308 are for rectovaginal takedowns, not colovaginal. My Mds define a colovaginal takedown when other sections of the bowels (not rectum) develop a fistula with the vaginal. This usually happens in cases in which the patient does not have a uterus (post hysterectomy). They differeniate between a rectovaginal and colovaginal. I would love to get feedback on this.....
Anna Barnes, CPC, CEMC
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