Part B Insider (Multispecialty) Coding Alert

New codes cover renal pelvis catheter procedures

Soon you won't have to use unlisted code 58999 to report vaginal graft revision any more. CPT has added CPT 57295 (Revision [including removal], vaginal approach).

"While we have a code for the revision of a sling procedure for stress urinary incontinence, the only way to report the revision of a vaginal graft was to use 58999," says Melanie Witt, an independent coding consultant in Guadalupita, NM.

Another 2006 addition is an add-on code for endometrial biopsies: 58110 (Endometrial sampling [biopsy] performed in conjunction with colposcopy [list separately in addition to code for primary procedure]).

The Correct Coding Initiative bundles existing endometrial biopsy code 58100 with all colposcopy codes that include a vaginal or cervical biopsy, including 57421 and 57454-57461.

"The new code, 58110, takes care of this problem because the resource-based relative value system (RBRVS) values this code for the intra-service work only," Witt says.

CPT 2006 also adds notes for colposcopy codes 57420-57421 and 57452-57461, stating you should use 58110 to report an endometrial biopsy in addition to these codes. The 57421 descriptor clarifies that it only covers a biopsy of the vagina and/or cervix. Because 58110 will be an add-on code, you won't need a modifier.

CPT 2006 also adds four new codes for renal pelvis catheter procedures. Two are for removal and replacement (50382) or just removal (50384) of an internally dwelling uretral stent via percutaneous approach. The other two cover removal and replacement (50387) or just removal (50389) of an externally accessible transnephric uretral stent requiring fluoroscopic guidance. All four codes include radiological supervision and interpretation.

There's also a new code for open ablation of one or more renal mass lesions via cryosurgery (50250). This code includes intraoperative ultrasound, if performed. You'll also have a new unlisted code for laparoscopic bladder procedures (51999).

The definition of 50688 will change to state that this code applies to changing either a uterorostomy tube or an externally accessible utereral stent via ileal conduit. The revised definitions of 62647-62648 remove the terms "contact" and "non-contact."