CPT® Code 51860

A cystorrhaphy is a surgical procedure specifically designed for the suture repair of a bladder wound, injury, or rupture. This procedure is indicated in cases where the bladder has sustained damage, which can manifest in various forms such as contusions with tears of the bladder mucosa, intraperitoneal lacerations or ruptures, interstitial injuries, extraperitoneal lacerations or ruptures, or a combination of these injuries. The procedure typically begins with the insertion of a Foley catheter to drain the bladder, ensuring that the surgical field is clear of urine. A vertical midline incision is then made in the abdomen to access the pelvic viscera, including the ureters, bowel, and blood vessels, which are carefully inspected for any additional injuries. The exterior of the bladder is also examined, and the dome of the bladder is opened to allow for a thorough inspection of its interior. During this process, any foreign bodies present are removed, and the ureteral orifices are checked for integrity. The specific bladder injury is localized, and any nonviable tissue is debrided to promote optimal healing. The closure of the bladder injury is performed in layers to ensure a watertight seal, and omental fat may be interposed to provide cushioning against potential pelvic fractures. After the closure, water or saline is instilled through the Foley catheter to verify that there is no leakage at the repair site. In some cases, a suprapubic catheter may be placed through a separate incision, along with a drain in the perivesical space, to facilitate postoperative care. Finally, the abdomen is closed in layers, completing the procedure. For a simple suture repair, the appropriate code to use is 51860, while a more complicated repair, which may involve additional factors such as foreign bodies or extensive nonviable tissue, is coded as 51865.