How To Use CPT Code 51900

CPT 51900 describes the closure of a vesicovaginal fistula using an abdominal approach. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 51900?

CPT 51900 is used to describe the closure of a vesicovaginal fistula using an abdominal approach. This procedure involves surgically repairing an abnormal opening between the urinary bladder and the vagina. It is typically performed following OB/GYN surgery for an enlarged uterus or other gynecological issues.

2. Official Description

The official description of CPT code 51900 is: ‘Closure of vesicovaginal fistula, abdominal approach. Note: For vaginal approach, see CPT codes 57320-57330.’

3. Procedure

1. The patient is brought to the operating room and placed in a supine position.
2. After administration of local anesthesia, a lower midline incision is made.
3. The surrounding vesical space is mobilized, and the peritoneum is detached from the bladder.
4. The bladder is opened by a longitudinal midline incision and then split posteriorly and downward towards the fistula.
5. The fistula, fistulous tract, and surrounding tissue are excised entirely.
6. The opening of the vagina is closed with absorbable sutures in single or multiple layers.

4. Qualifying circumstances

CPT 51900 is performed when there is a vesicovaginal fistula, which is an abnormal opening between the urinary bladder and the vagina. This condition often occurs following OB/GYN surgery. The procedure is typically performed by a surgeon using an abdominal approach. It is important to note that for closure of a vesicovaginal fistula via a vaginal approach, different CPT codes (57320-57330) should be used.

5. When to use CPT code 51900

CPT code 51900 should be used when a surgeon performs the closure of a vesicovaginal fistula using an abdominal approach. It is important to ensure that the procedure is performed specifically for the closure of a vesicovaginal fistula and not for any other condition or purpose.

6. Documentation requirements

To support a claim for CPT 51900, the following documentation is required:

• Patient’s diagnosis of a vesicovaginal fistula
• Description of the procedure performed, including the approach used (abdominal)
• Date of the procedure
• Details of the closure technique used
• Any additional relevant information or findings

7. Billing guidelines

When billing for CPT 51900, it is important to ensure that the procedure was performed using an abdominal approach for the closure of a vesicovaginal fistula. It should not be reported if the procedure was performed using a vaginal approach (CPT codes 57320-57330). Additionally, if the closure of a vesicovaginal fistula is performed laparoscopically, an unlisted laparoscopy procedure code (51999) should be used. It is recommended to include a copy of the operative report and a covering letter explaining the procedure in layman’s terms to ensure appropriate reimbursement.

8. Historical information

CPT code 51900 was added to the Current Procedural Terminology system on January 1, 1990. The only historical change to note is that it was added under the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A surgeon performs the closure of a vesicovaginal fistula using an abdominal approach.
2. A patient undergoes surgery to repair a vesicovaginal fistula caused by a previous gynecological procedure.
3. A surgeon excises the fistula and surrounding tissue and closes the opening of the vagina with absorbable sutures.
4. A patient with a vesicovaginal fistula undergoes a successful abdominal closure procedure.
5. A surgeon uses CPT code 51900 to bill for the closure of a vesicovaginal fistula performed via an abdominal approach.
6. A patient’s vesicovaginal fistula is repaired using an abdominal approach, and the procedure is documented accordingly.
7. A surgeon performs the closure of a vesicovaginal fistula using an abdominal approach, ensuring complete excision of the fistula and surrounding tissue.
8. A patient’s vesicovaginal fistula is successfully closed using absorbable sutures in multiple layers.
9. A surgeon performs the closure of a vesicovaginal fistula using an abdominal approach, achieving a successful outcome.
10. A patient undergoes a vesicovaginal fistula closure procedure, and the opening of the vagina is effectively closed with absorbable sutures.