# NAME OF PROCEDURE:  Cystoscopy with left stone manipulation with stent placement



## bailsb (Jan 13, 2011)

Can anyone help?  I'm thinking 52332, 52352-51, and 74480-26

NAME OF PROCEDURE:  Cystoscopy with left stone manipulation with stent placement
under fluoroscopic guidance.

DESCRIPTION OF PROCEDURE:  After he was prepped and draped in the supine manner,
he was placed in the lithotomy position.  Cystoscopy was unremarkable, the
bladder orifices were normal.  A guidewire was placed up the left side in the
kidney under fluoroscopic guidance, and a faint shadow of the stone could be
identified.  A dual-lumen catheter retrograde confirmed hydronephrosis and the
filling defect at the ureteropelvic junction.  This was quite large stone.  We
were able to manipulate the wire past the stone, and then a stent was placed.
At the end of the procedure, there was good curl in the kidney and bladder.  It
was drained.  There was no extravasation.  He tolerated the procedure well and
was taken to the recovery room in stable condition.


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## Karyzmagirl (Jan 14, 2011)

I would code this as 52352, 52332 51 modifier for commercial payers/ 59 modifier for medicare (I always add my LT or RT modifiers to the stent as well). 74480-26 modifier


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## Karyzmagirl (Jan 14, 2011)

Retrograde urography (pyelography) is imaging performed after the injection of contrast through a catheter placed into the ureter via the urethra and bladder. The imaging may be interpreted by a radiologist, although the surgical portion of the procedure is most often performed by another physician (ie, urologist) in the OR Cysto Suite. Code for the interpretation of imaging for retrograde urography (pyelography) with 74420 -26.

i would check to see if this is the correct code, looks like the Dr. may have done retrograde....just a thought.


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## bailsb (Jan 14, 2011)

*Help much appreciated.*

Thank you.  I will review the Fluoroscopy codes.


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## Kelly_Mayumi (Jan 15, 2011)

I would only 52332 and 74420-26.  The stone was not basket extracted.  It's likely the urologist is trying to let the stone pass on it's own.


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