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September 2004 · Vol. 16, No. 9

REIMBURSEMENT ADVISER

Replacing eroded sling mesh

MELANIE  WITT,  RN, CPC, MA

Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

Q

A patient underwent a sling operation last year, but the mesh didn’t hold. She’s scheduled to have the eroded mesh replaced, but I can’t find a good diagnosis code.

A

There actually is a very good diagnosis code: 996.76 (other complications of internal [biological] [synthetic] prosthetic device, implant, and graft; due to genitourinary device, implant, and graft). This is acceptable as the primary diagnosis. Use it in conjunction with CPT code 57287 (removal or revision of sling for stress incontinence [eg, fascia or synthetic]).

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