Anesthesia Coding Alert

Reader Questions:

Stone Location Guides Cysto-With-Litho Coding

Question: How should I code for anesthesia during a cystourethroscopy with lithotripsy for a diagnosis of kidney or ureteral stones?

Illinois Subscriber

Answer: The 2007 Crosswalk added a note to CPT codes 52352-52355 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy ...) stating to report 00862 (Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy) when lithotripsy involves the kidney or upper one-third of the ureter. Because of this "upper one-third" distinction, you'll need a copy of the operative report to code accurately.

Many coders gauge their coding by the stones' location. They submit 00910 (Anesthesia for transurethral procedures [including urethrocystoscopy]; not otherwise specified) for a bladder stone, 00918 (... with fragmentation, manipulation and/or removal or ureteral calculus) for a ureter stone, and 00862 for a kidney stone.

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