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The CPT® Code 53444 refers to the procedure of inserting a tandem cuff, also known as a dual cuff, which is a component of an artificial urinary sphincter (AUS) system. This procedure is typically indicated when there is a failure of the initially placed cuff, necessitating a replacement to restore proper urinary control. The insertion involves a surgical incision made at the bulbous urethra, the anatomical location where the cuff is situated. During the procedure, the existing cuff is carefully exposed and mobilized to allow for its removal. The tubing connected to the cuff is clamped, and the cuff is detached from the urethra. Following this, the diameter of the urethra is measured to ensure the correct sizing of the new cuffs. Two cuffs are then positioned around the urethra and linked to the existing tubing of the AUS system. After the placement, the AUS system is activated, and the bladder is filled to assess the functionality of the cuffs, checking for any signs of leakage. Once it is confirmed that the system is operating effectively without leakage, the surgical incision is closed, completing the procedure.
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The procedure described by CPT® Code 53444 is indicated in specific clinical scenarios where the initial artificial urinary sphincter (AUS) system has failed. The following conditions may warrant the insertion of a tandem cuff:
The procedure for the insertion of a tandem cuff involves several critical steps, each essential for ensuring the successful placement and functionality of the new cuff:
Post-procedure care following the insertion of a tandem cuff involves monitoring the patient for any complications and ensuring the proper functioning of the AUS system. Patients may be advised to follow specific guidelines regarding activity levels and fluid intake to promote healing and assess the effectiveness of the new cuffs. Regular follow-up appointments may be scheduled to evaluate the patient's urinary control and to address any concerns that may arise during the recovery period.
| Short Descr | INSERT TANDEM CUFF | Medium Descr | INSERTION TANDEM CUFF | Long Descr | Insertion of tandem cuff (dual cuff) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 109 - Procedures on the urethra |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2002-01-01 | Added | First appearance in code book in 2002. |
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