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The CPT® Code 57267 refers to the insertion of mesh or other prosthetic material for the repair of a pelvic floor defect, specifically addressing each site involved, which includes the anterior and posterior compartments, through a vaginal approach. This procedure is typically performed in conjunction with other surgical interventions such as anterior and/or posterior colporrhaphy and/or rectocele repair, which are separately reportable. During the procedure, the physician makes an incision in the vaginal wall to gain access to the underlying supportive structures, including muscles, fascia, and ligaments that are essential for pelvic floor integrity. The mesh or prosthetic material is then tailored to fit the specific dimensions required for the repair, ensuring that it adequately supports the pelvic floor. In some cases, a preconfigured mesh implant may be utilized to facilitate the repair process. The placement of the mesh involves securing it over the affected fascia and anchoring it to the underlying musculature, effectively addressing the defect in the pelvic floor. It is important to report code 57267 for each compartment that is repaired using mesh, highlighting the procedure's specificity and the need for accurate coding in relation to the surgical interventions performed.
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The procedure associated with CPT® Code 57267 is indicated for the repair of pelvic floor defects that may lead to conditions such as pelvic organ prolapse. The following are specific indications for performing this procedure:
The procedure for CPT® Code 57267 involves several critical steps to ensure effective repair of the pelvic floor defect:
Post-procedure care following the insertion of mesh for pelvic floor repair is essential for optimal recovery. Patients are typically monitored for any immediate complications, such as bleeding or infection. Instructions for post-operative care may include recommendations for activity restrictions, pain management, and signs of potential complications to watch for. Patients are often advised to avoid heavy lifting and strenuous activities for a specified period to allow for proper healing. Follow-up appointments are crucial to assess the surgical site and ensure that the mesh is functioning as intended, as well as to address any concerns the patient may have during their recovery process.
| Short Descr | INSERT MESH/PELVIC FLR ADDON | Medium Descr | INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE | Long Descr | Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 2 | CCS Clinical Classification | 129 - Repair of cystocele and rectocele, obliteration of vaginal vault |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 45560 | MPFS Status: Active Code APC J1 ASC A2 Physician Quality Reporting Illustration for Code Repair of rectocele (separate procedure) | 57240 | Female Edit MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed | 57250 | Female Edit MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy | 57260 | Female Edit MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; | 57265 | Female Edit MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair | 57285 | Female Edit MPFS Status: Active Code APC J1 CPT Assistant Article Illustration for Code Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach |
| 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GC | This service has been performed in part by a resident under the direction of a teaching physician | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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). | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AG | Primary physician | CR | Catastrophe/disaster related | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2005-01-01 | Added | First appearance in code book in 2005. |
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