Results 1 to 7 of 7

CPT code for exloration of fistula

  1. #1
    Default CPT code for exloration of fistula
    Medical Coding Books
    Can anyone help me with the correct CPT code to use for transperineal exploration of a rectourethral fistula?

    The other procedures are:
    Cystourethroscopy (I am using 52000) and Urethroplasty (53410) with a diagnosis of 599.1.

    There was another surgeon who did a procedure after this and is using 45505.

    I have just started coding surgeries for a urologist, so I would appreciate any help, including any resources you might suggest that would be helpful.
    Last edited by Janie751; 06-09-2008 at 01:12 PM. Reason: to allow email notification

  2. #2
    does he repair the fistula? If so see 46470.

  3. #3
    Yes, he does repair the fistula. I could not find the code 46470, could this be a deleted code? Thank you for responding.

  4. #4
    sorry I transposed the CPT, try 46740

  5. #5
    I had to look up "imperforate" to see what it means. This does not apply in this case because it said having no opening or lacking the usual and normal opening. I have been looking at code 53415 and thinking it might be better than using 53410. After looking at detailed information about this code, I am wondering if it might include the exploration. Thank you again for responding and I welcome any other suggestions you might have.

  6. #6
    Milwaukee WI
    Default 22 modifier
    This is NOT my area of expertise, but ...
    Have you considered adding the [22] modifier to 53410 (or 53415) to indicate the additional work of the exploration/repair of the fistula? You would also increase your fee. Be prepared to attached supporting documentation, and possible to appeal for additional reimbursement.
    F Tessa Bartels, CPC

  7. #7
    I did not think about using the modifier. I will do some more research and see if that might work. Thank you for taking the time to respond.

Similar Threads

  1. CPT for Excision of Fistula
    By Chelsey3 in forum Cardiovascular Thoracic
    Replies: 1
    Last Post: 06-23-2011, 06:55 AM
  2. excision of neck fistula cpt code!
    By in forum ENT/Otolaryngology
    Replies: 1
    Last Post: 02-22-2011, 02:48 PM
  3. cpt code for ligation of tributaries for av fistula
    By carol52 in forum General Surgery
    Replies: 1
    Last Post: 01-05-2011, 03:59 PM
  4. cpt code for excision of retro peritoneal fistula
    By carol52 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 01-28-2010, 12:03 PM
  5. superficialization of av fistula CPT
    By BwitchyCoder in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 07-24-2008, 10:53 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.