# Cystoscopy, R stent insertion, bladder stone extraction



## emilyadams1993@yahoo.com (Feb 18, 2016)

Pre-operative Diagnosis: Obstructing R stone




Post-operative Diagnosis: Obstructing R stone




Procedure: Cystoscopy, R stent insertion, bladder stone extraction






Operative Indications:

 61 y.o. male with an obstructing R-sided stone with concern for sepsis. The risks of the procedure including, but not limited to, pain, bleeding, infection, and ureteral injury, were explained to the patient and he elected to proceed. Informed consent was obtained.  

Operative Procedure:

The patient was taken to the operating room and placed supine on the operating table.  Pre-operative antibiotics were administered.  Bilateral lower extremity SCDs were placed.  After induction of general anesthesia the patient was positioned in dorsal lithotomy, prepped and draped in a sterile fashion.  A time-out was performed.  



A 14F flexible cystoscope was passed carefully via urethra into the bladder.  A Sensor wire was passed retrograde through the right ureteral orifice.  A 6  x 26 French ureteral stent was placed in retrograde fashion under fluoroscopic guidance with good coil confirmed to be in by the 11/12 rib and in the bladder. A bladder stone was visualized in near the bladder neck and extracted with a snare. The patient tolerated the procedure well. The bladder was emptied.

I think this is 52332. another says 52310.


I do not think we can use 52310. I think it is 52332. The stone extraction would be integral to the procedure- Per CCI Guidelines, Procedure Code 52310 has a CCI Conflict with Procedure Code 52332. A modifier is not allowed.

Any opinions?


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## syllingk (Feb 18, 2016)

I agree. 52310 says it has to be a separate procedure so if it is done with 52332 it would not be reported.


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## michelleaapc2012 (Mar 25, 2016)

I would go with 52332.


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