How To Use CPT Code 51990

CPT 51990 describes a laparoscopic surgical procedure known as urethral suspension for stress incontinence. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 51990?

CPT 51990 is a code used to describe a laparoscopic surgical procedure called urethral suspension. This procedure involves the surgical suspension of the urethra by placing sutures and stitching it to the surrounding tissue. It is performed using a laparoscope, which is a thin tube with a camera at one end. Urethral suspension is typically done to treat stress incontinence, which is the inability to control urine.

2. Official Description

The official description of CPT code 51990 is: ‘Laparoscopy, surgical; urethral suspension for stress incontinence.’

3. Procedure

1. The provider begins by making a small incision beneath the umbilicus (navel) and inserting a laparoscope to visualize the abdominal organs.
2. Using the laparoscope, the provider locates the urethra and bladder.
3. Another small incision is made on the side of the abdomen to insert surgical instruments.
4. The provider then suspends the urethra by placing sutures and stitching it to the surrounding tissue.
5. The sutures are pulled taut to provide extra support and resistance against urine leakage.
6. All bleeding is stopped, and the laparoscope and surgical instruments are withdrawn.
7. The incisions are sutured closed.

4. Qualifying circumstances

Urethral suspension is performed for patients with stress incontinence, a condition characterized by the inability to control urine. The procedure is typically done by a provider using a laparoscope. The patient must meet the criteria for stress incontinence and have a medical need for urethral suspension. The provider must document the patient’s diagnosis and the medical necessity for the procedure.

5. When to use CPT code 51990

CPT code 51990 should be used when a laparoscopic urethral suspension procedure is performed for the treatment of stress incontinence. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure does not meet the criteria, a different code may be more appropriate.

6. Documentation requirements

To support a claim for CPT code 51990, the provider must document the following information:

• Patient’s diagnosis of stress incontinence
• Medical necessity for urethral suspension
• Details of the laparoscopic procedure, including the incisions made, use of laparoscope, and suturing of the urethra
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 51990, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The provider should also follow any additional billing guidelines provided by the payer. It is important to accurately report the procedure and any associated services or supplies. It is also important to ensure that the documentation supports the medical necessity of the procedure.

8. Historical information

CPT code 51990 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates to the code since its addition.

9. Examples

1. A patient with stress incontinence undergoes a laparoscopic urethral suspension procedure to improve bladder control.
2. A provider performs a laparoscopic urethral suspension with sling for a patient with stress incontinence.
3. A laparoscopic urethral suspension procedure is performed using a graft to treat stress incontinence in a patient.
4. A provider performs a laparoscopic urethral suspension with mesh to address stress incontinence in a patient.
5. A laparoscopic urethral suspension procedure is performed using autologous tissue to treat stress incontinence in a patient.