# Biopsy bladder and prostatic urethra



## msmileyb

Cpt 52204 is bundled into 52601. The biopsies were done in 2 different sites during the post op period. Should a modifier 59 be used to unbundle the cold cup biopsy?


After the bladder has been fully visualized, cold cup biopsies were taken initially of the right lateral wall, which was the area of the possible urothelial abnormality followed by posterior wall, trigone, and left lateral wall. Each biopsy site was fulgurated witha Bugbee electrode. Hemostasis was assured.
At this point the cystoscope was removed and replaced with a #25 continuous flow ACMI resectoscope.
At this point TUR biopsies were taken of the remaining urethra. Mucosa was resected circumerentially. Hemostasis was then assured with a resectoscope.

The pat had a TUR 2 months earlier and is back during post op period


52601 mdf 76 - TUR
52204 mdf 59/79 - Cold cup biopsy


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## magnolia1

Was the TUR of the prostate a planned two stage procedure?

If so, your CPT for this session would be 52614 and it is not bundled with 52204.


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## msmileyb

I hope this helps.


Indications: The patient is status post TURP, which demonstrated a probable TCC of the prostatic urethra. Therefore the pat was brought back to the OR for TUR biopsies of the prostatic urethra and random biopsies of the bladder.


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## magnolia1

Do you have access to a Coders' Desk Reference?

I think 52204 will cover both procedures.


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## magnolia1

Disregard my previous statement.

In re-reviewing your first message, you need to look at codes 
52214--52240 depending on size of bladder lesions that were fulgurated following biopsy.

Please let me know what you come up with.


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## jbnewlife77

If fulgaration is done after biopsy to stop the bleeding you wouldonly code the biopsy, and not the fulgaration.


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