How To Use CPT Code 57287

CPT 57287 describes the procedure for the removal or revision of a sling used to correct stress urinary incontinence. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 57287?

CPT 57287 is used to describe the removal or revision of a sling that was placed under the urethra to correct stress urinary incontinence. This procedure is performed when the sling is eroding, infected, causing urinary retention, or protruding from the site. The surgery can be done through a vaginal or combination vaginal and abdominal approach.

2. Official Description

The official description of CPT code 57287 is: ‘Removal or revision of sling for stress incontinence (eg, fascia or synthetic).’ There are no additional notes or modifiers specified for this code.

3. Procedure

1. The provider administers anesthesia and prepares the patient for the procedure.
2. The patient is placed in a dorsal lithotomy position.
3. A vaginal incision is made in the anterior vaginal vault, avoiding direct contact with the urethra.
4. The incision is extended to the graft material, and the provider releases the graft material from the surrounding tissue.
5. If the sling has been attached above the urethra, a small abdominal incision may be made to reach that area and cut the attachment or adjust the sling.
6. A cystoscopy may be performed to ensure there is no graft material in the bladder and to check for any damage to the urethra.
7. The incision sites are irrigated, checked for bleeding, and closed with sutures. The vagina may be packed.

4. Qualifying circumstances

CPT 57287 is performed on patients with stress urinary incontinence who have a sling that needs to be removed or revised. The sling may be causing complications such as erosion, infection, urinary retention, or protrusion. The procedure is typically performed by a provider in a hospital setting.

5. When to use CPT code 57287

CPT code 57287 should be used when a provider performs the removal or revision of a sling for stress urinary incontinence. It is important to ensure that the documentation supports the medical necessity of the procedure and that it is performed in the appropriate setting.

6. Documentation requirements

To support a claim for CPT code 57287, the provider must document the following information:

• Reason for the removal or revision of the sling
• Details of the procedure, including the approach used (vaginal or combination vaginal and abdominal)
• Any complications encountered during the procedure
• Use of cystoscopy and findings
• Incision site irrigation and closure

7. Billing guidelines

When billing for CPT code 57287, it is important to ensure that the documentation supports the medical necessity of the procedure and that it is performed in the appropriate setting. This code should not be reported with other codes unless there are separate and distinct procedures performed. It is also important to follow any specific billing guidelines provided by payers.

8. Historical information

CPT code 57287 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs the removal of a sling for stress urinary incontinence in a patient who is experiencing erosion of the sling material.
2. A patient presents with a sling that has become infected, and the provider performs a revision of the sling to address the infection.
3. A provider performs the removal of a sling for stress urinary incontinence in a patient who is experiencing urinary retention.
4. A patient presents with a sling that is protruding from the site, and the provider performs a revision of the sling to correct the protrusion.
5. A provider performs the removal of a sling for stress urinary incontinence using a combination vaginal and abdominal approach in a patient with complications from the sling.
6. A patient undergoes a revision of a sling for stress urinary incontinence with cystourethroscopy to assess the condition of the urethra and bladder.
7. A provider performs the removal of a sling for stress urinary incontinence and performs urethrolysis to release any adhesions or scar tissue.
8. A patient undergoes a revision of a sling for stress urinary incontinence with cystourethroscopy, urethrolysis, and repositioning of the sling to improve its effectiveness.
9. A provider performs the removal of a sling for stress urinary incontinence and performs cystoscopy to ensure there is no graft material in the bladder.
10. A patient undergoes a revision of a sling for stress urinary incontinence with cystourethroscopy, urethrolysis, repositioning of the sling, cystoscopy, and urethral dilation to address multiple complications.