Summary & Overview
CPT 51845: Bladder Neck Suspension for Female Stress Urinary Incontinence
CPT code 51845 denotes a bladder neck suspension procedure performed to treat female stress urinary incontinence by anchoring peri‑vesical tissues to the abdominal fibrous tissue. This operative intervention is a recognized surgical option to reduce urine leakage associated with coughing, sneezing, laughing, or exertion and remains relevant in surgical urology and gynecology care pathways.
Key payers considered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context, typical sites of service, and the kinds of benchmarks and policy considerations payers and providers monitor for this procedure. The publication summarizes common billing modifiers associated with surgical procedures and highlights what is available and what is not: where input fields lacked information, the report notes "Data not available in the input."
The report is organized to help billing managers, surgical clinicians, and policy analysts understand the role of CPT code 51845 in care delivery, reimbursement workflows, and payer coverage discussions. It outlines expected documentation and service settings, offers comparisons across major payers, and flags areas where further data collection would clarify utilization and policy trends.
Billing Code Overview
CPT code 51845 describes a surgical procedure to treat female stress urinary incontinence by suspending the bladder neck. The surgeon anchors tissues on each side of the bladder neck and sutures them to the fibrous tissue of the abdomen to restore continence during increases in intra‑abdominal pressure.
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Service type: Surgical repair for urinary incontinence (bladder neck suspension)
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Typical site of service: Hospital operating room or ambulatory surgical center where gynecologic or urologic pelvic surgeries are performed
Clinical & Coding Specifications
Clinical Context
A 56-year-old parous woman presents with a multi-year history of stress urinary incontinence characterized by urine leakage with coughing, sneezing, laughing, and exercise. Conservative measures including pelvic floor physical therapy and pessary use have failed to produce sustained benefit. Urodynamic testing demonstrates urethral hypermobility without intrinsic sphincter deficiency. The patient elects a bladder neck suspension procedure to elevate and stabilize the bladder neck.
Preoperative workflow includes history and physical, urodynamic study review, informed consent, preoperative anesthesia assessment, and appropriate pre-op labs and imaging as indicated. The procedure is performed in an operating room under general or regional anesthesia. The surgeon identifies periurethral and bladder neck tissues, places sutures on each side of the bladder neck and anchors them to the abdominal (rectus fascia or Cooper's ligament/fascia) fibrous tissue to restore urethral support. Intraoperative cystoscopy may be performed to confirm urethral and bladder integrity. Postoperative workflow includes recovery room monitoring, voiding trial prior to discharge or catheter management, postoperative follow-up for wound check and continence assessment, and documentation of procedure, findings, materials, and any intraoperative complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/Not specified | Use when no modifier applies and the payer accepts unmodified codes |