# Cystourethoroscopy w/dilation of bladder with bladder irrigation



## lcole7465 (Aug 18, 2017)

I'm new to Urology coding and I have a procedure that was performed and 51700-51 is being denied as inclusive. It was coded with 52260. The op report reads:

 The cystoscope was advanced per urethra into the bladder and panendoscopy was performed demonstrating absence of mucosal defects within the bladder, the bladder neck and the urethra. Ureteral orifices are in normal position. The bladder was stretched to maximum capacity under gravity drainage and remained stretched in this manner for a total of 8 minutes at which time the bladder was drained of all fluid. The terminal portion of the drainage was minimally grossly bloody.  The volume measured was 500 mL. Cystoscopy was then repeated demonstrating a moderate amount of glomerulation throughout the bladder. The bladder was drained of all fluid and the cystoscope was removed.  A 14-French red rubber catheter was advanced into the bladder and the DMSO solution containing also Kenalog, bicarb and heparin was instilled into the bladder, and once within, the catheter was removed leaving the fluid within the bladder. 

I haven't been able to find anything that these are inclusive. Any help on this would be appreciated.


----------



## sequester25@gmail.com (Aug 18, 2017)

52260 - Per www.supercoder.com

Clinical Responsibility
With the patient under general or spinal anesthesia,the physician inserts the tip of the cystoscope (a flexible or rigid scope depending on the purposes of the physician) into the urethra and slowly glides it up and into the bladder. The camera attached to the cystoscope allows images of the bladder to be viewed on a monitor. The physician examines the urethra and injects sterile saline water into the bladder to dilate the bladder and improve the view of the bladder wall. Some patients notice temporary improvement in symptoms just with bladder dilation. *The provider may also instill a combination of medications, such as lidocaine, sodium bicarbonate, and pentosan to reduce bladder irritation and treat the interstitial cystitis. If the condition fails to improve, this treatment may need to be repeated. After instillation of fluids and a brief delay to allow the medications to work, the bladder is drained and the instruments removed.*

with the excerpt you provided I would have only billed the 52260 because it seems the drug cocktail is included to treat the cystitis as seen in the bold text

hope this helps


----------

