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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
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    does he repair the fistula? If so see 46470.

  3. #3
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    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
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    ENGLEWOOD/DENVER
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    sorry I transposed the CPT, try 46740

  5. #5
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    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
    Location
    Milwaukee WI
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    4,466
    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
    Default
    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.

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