# urology cpt 52005 and 52332



## aparscal (Dec 21, 2015)

My Doctor is billing a 52005 and 52332. I see where he did the 52332, but I'm not sure about the 52005.
Preop dx: Pyelonephritis with sepsis
Right uretral stone
Hydronephrosis
Post Op Dx:same
Operation: Cystoscopy with ureteral stenting and retrograde pyelography, Ct Imaging demonstrated a 5 mm stone obstructing the right proximal ureter with hydronephrosis.
Description of procedure:
After the anesthetic was administered patient was placed in the dorsal lithotomy position, and prepped and draped in the routine fashion. The urethral meatus was identified.The cystoscopic sheath introduced into the bladder. The bladder had a urine suggesting infectious change.There were some erythematous patchy changes within the bladder. Ther right ureteral orifice was identified. There was no evidence of any efflux of urine. An 0.35 wire was negotiated into the ureter and impacted into the stone., which was in serpentine position at the proximal ureter.
Attempts to bypass this were unsuccessful. An open-ended catheter was changed and still we were unable to manipulate past the stone.Retrograde contrast was gently injected,defining the course of the ureter better. A Newton wire was then positioned and manipulated into the collecting system. The open ended catheter was removed and a 6 x 24 stent positioned fluoroscopically and endoscopically, in good position. The bladder was decompressed and the procedure was terminated. 

Fluorscopic report:
Fluoroscopic imaging demonstrates contrast in the proximal ditlated ureter,suggesting a stone defect. A wire was manipulated at this point and not able to pass beyond because of the serpentine change. Contrast injection defines hte course of the ureter and subsequently a wire was passed and a stent was positioned satisfactorily.

I do see the 52332 where a 6 x24 stent was positioned, but not sure about 52005 it looks like it was unsuccessful, an open-ended catheter was changed and they were still unable to manipulate the stone. Then, retrograde contrast was injected  and he was able to define the course for the ureter better, can we charge a 74420 Urography,retrograde, with or w/o KUB
Please let me know what you think, thank you


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## hdanner7 (Dec 23, 2015)

It looks to me like he does insert it:
"An open-ended catheter was changed and still we were unable to manipulate past the stone." - Earlier he says the stone was in the proximal ureter, so they must have been able to get the catheter into a portion of the ureter, just not past the stone.  Because then he goes on to say "The open ended catheter was removed..." before inserting the double J stent.

This looks like it supports both 52005 and 52332.


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## Kelly_Mayumi (Dec 29, 2015)

However, did you run bundling edits to make sure these two codes can be reported together?


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## JEYCPC (Dec 30, 2015)

52332 includes 52005.  Can be unbundled for example if done on different sides.


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## michelleaapc2012 (Mar 25, 2016)

I agree 52005 is included in 52332


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