2025 CPT code 53444
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Urinary System Feed
Insertion of a tandem cuff (dual cuff) for urinary incontinence.
Modifiers may be applicable in certain situations, such as increased procedural services (22), multiple procedures (51), or reduced services (52). Refer to current modifier guidelines for appropriate use.
Medical necessity is established by demonstrating that the patient has significant urinary incontinence refractory to conservative treatments, impacting their quality of life. The chosen procedure must be appropriate for the patient's specific condition and health status.
The surgeon is responsible for patient preparation, anesthesia, the surgical insertion of the tandem cuff, connecting it to the pump, controlling bleeding, and closing the surgical site. Accurate measurement of the urethra is crucial for selecting the correct cuff size.
In simple words: A second cuff is placed around the urethra to help control severe urinary leakage, especially when a previous device isn't working well enough. This involves a small cut below the scrotum, carefully placing the cuff, and connecting it to a pump under the skin.
This procedure involves inserting a second cuff in patients with urinary incontinence, often when a previously inserted artificial urinary sphincter is insufficient or for patients with high-grade stress incontinence. The procedure involves making a perineal incision, dissecting tissue around the urethra, measuring the urethra to determine the appropriate cuff size, tying the tandem cuff around the urethra, and connecting tubing from the cuff to a control pump typically placed in a suprapubic wound. The incision is then closed in layers.
Example 1: A patient with an existing artificial urinary sphincter experiences persistent stress incontinence. A tandem cuff (53444) is inserted to augment the existing sphincter and improve continence., A patient with high-grade stress incontinence, not suitable for a standard artificial sphincter, undergoes insertion of a tandem cuff system as the primary treatment., A patient with recurrent stress incontinence after a prostatectomy has a tandem cuff inserted to enhance urinary control.
Documentation should include the medical necessity for the procedure (e.g., severity of incontinence, failure of conservative management, patient's suitability for surgery), details of the surgical technique, size of the cuff used, location of the pump placement, and any intraoperative complications. Preoperative and postoperative assessments should also be documented.
- RVU: RVUs vary depending on the payer. Refer to the relevant fee schedule for specific RVU information.
- Global Days: 90 days
- Specialties:Urology
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, Outpatient Hospital