# Cystoscopy with retrograde pyelogram and ureteral stent exchange



## MMontero@swhealth.com

Can I ask for your thoughts about this one?

Patient had undergone cystoscopy with ureteral stent exchange and after placement, a retrograde pyelogram was done to ensure the correct placement of the stents. I used 52332 for the stent exchange. Is it still needed to add 52351 for the retrograde pyelogram? Or pyelogram is already integral with the procedure?

I would appreciate all your thoughts on this one.


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## Venkatakrishnan

Hi MLMontero,

For retrograde pyelogram, we use CPT 52005 which is also bundled with CPT 52332. So 52005 is not needed.

Thanks,
Vernon Kreiss


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## ablamb12

If physician completes cystourethroscopy, with insertion of indwelling ureteral stent w/ retrograde pyelogram. 52332 would be used for the stent exchange. 52005 is included in 52332. 52005 may be unbundled from 52332 if you can justify the use of an appropriate modifier. If you are unable to justify the use of a modifier, you may only bill 52332. If you bill both, 52005 should receive the modifier. Either route you go coding this procedure; you may code 74420 with the -26 modifier (professional component) for the interpretation/reading of the xrays. 
Hope this gives you some direction on coding this procedure.


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