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The CPT® Code 51841 refers to a surgical procedure known as anterior vesicourethropexy or urethropexy, which is commonly recognized by the names Marshall-Marchetti-Krantz or Burch procedure. This operation is specifically designed to address urinary incontinence in women, a condition often resulting from the stretching of pelvic ligaments associated with vaginal wall prolapse. During the procedure, the surgeon makes an incision in the abdomen to gain access to the bladder neck and urethra. The surgical technique involves suspending the prolapsed vaginal wall and urethra to restore proper anatomical positioning and function. The procedure is characterized as complicated, indicating that it may involve secondary repair due to previous unsuccessful attempts at bladder suspension. The use of sutures through the paravaginal fascia and their attachment to structures such as Cooper's ligament or the pubic bone is critical for providing the necessary support to the bladder and urethra. It is important to note that this code is distinct from CPT® Code 51840, which is used for simpler bladder suspension procedures in patients who have not undergone prior surgical interventions.
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The anterior vesicourethropexy or urethropexy procedure, represented by CPT® Code 51841, is indicated for the treatment of urinary incontinence in women, particularly when this condition is associated with pelvic organ prolapse. The following specific indications apply:
The anterior vesicourethropexy or urethropexy procedure involves several critical steps to ensure effective treatment of urinary incontinence. The following procedural steps are outlined:
After the anterior vesicourethropexy or urethropexy procedure, patients typically require monitoring for any immediate complications. Post-operative care may include pain management, monitoring for signs of infection, and ensuring proper healing of the surgical site. Patients are often advised on activity restrictions to promote recovery and prevent strain on the surgical area. Follow-up appointments are essential to assess the success of the procedure and to address any ongoing issues related to urinary incontinence or complications from the surgery.
| Short Descr | ATTACH BLADDER/URETHRA | Medium Descr | ANT VESICOURETHROPEXY/URETHROPEXY COMP | Long Descr | Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair) | 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 | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 106 - Genitourinary incontinence procedures |
| 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). | 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | LT | Left side (used to identify procedures performed on the left side of the body) |
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| Pre-1990 | Added | Code added. |
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