Wiki Removal of vaginal mesh that has migrated into the urinary bladder

[jjjones]

Which code would I submit for laparoscopic removal of vaginal mesh that has migrated to the bladder. I'm reviewing CPT 57426 in addition to CPT 51999 for closure of the bladder defect (comparable CPT code 51860 vs 51865). I'm not sure it would be appropriate to bill for the closure of the bladder separately (inherent in removing the mesh). Please advise.

 

[daniel]

Only code 57426, closure of bladder would be integral. Lay description states
The physician revises or removes a previously placed prosthetic vaginal graft via a laparoscopic approach. Through small stab incisions in the umbilicus and/or abdomen, a fiberoptic laparoscope and trocars are inserted into the peritoneal cavity. Depending upon the type of complication (e.g., mesh erosion into the bladder or persistent vaginal/pelvic pain), the vaginal graft may be completely or partially excised to remove eroding mesh or revisions may be made in the graft and surrounding tissue.