Reimbursement Advisor

Can perineoplasty be coded with A&P repair?

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Q We billed an A&P repair using CPT code 57260 and perineoplasty with CPT 56810-51. It was denied as bundled. Should I have used modifier -59 (distinct procedure)?

A No. Perineoplasty is the same thing as perineorrhaphy. Since this procedure is included with a posterior repair (code 57250) and you are billing for a combined posterior and anterior repair, the perineoplasty would be included in code 57260 as well.

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.

OBG Management ©2005 Dowden Health Media

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