# Urethral stone removal



## Emmalia (Mar 27, 2014)

I don't know if I am looking too far into this but I could definitely use a little insight.
Patient has a urethral stone along with a ureteral stone. Provider passes a cystoscope and pushes the urethral stones into the bladder and then breaks them up using a laser. The passes a urethroscope into the ureter to try to break up the ureteral stones, but is unsuccessful in reaching the stones. A double J stent is then inserted.
I'm looking at using code 52317-Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small and then using 52351-Cysto with ureteroscopy; diagnostic. There are no CCI edits with these two codes but the insurance is denying as inclusive. Now I'm wondering does code 52352-Cysto with ureteroscopy; with removal or manipulation of calculus, include removal of a calculus that is anywhere in the urinary system or does it have to be in the ureters?

Any insight would be appreciated. Thanks!


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## msdrea32208 (Mar 27, 2014)

52353 is a cystourethroscopy with removal and manipulation of calculus with lithotripsy. Sounds like this one code encompasses all that you mentioned about the procedure. You would add 52332 for the stent with a 51 modifier


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