Urology Coding Alert

Plus, if your doctor performs urogynecology procedures you'll have new edits to take into account.

While the Correct Coding Initiative (CCI) often wreaks havoc on your coding, you'll be glad to know that version 17.2 doesn't bring many new urology-related edits. CCI Edits version 17.2, which takes effect July 1, offers 2,367 new edit pairs and deletes 336 bundles, according to an analysis by Frank Cohen, MPA, MBB, principal and senior analyst with The Frank Cohen Group, LLC. The majority of edits impact the codes from the musculoskeletal code range (20000-29999), but bundles did occur to codes throughout the CPT® manual. Here's a rundown of the new CCI bundles you might run into in your urology practice.

Watch Out For More Catheterization Bundles

CCI 17.2 bundles urethral catheterization codes 51701 (Insertion of non-indwelling bladder catheter [eg, straight catheterization for residual urine]), 51702 (Insertion of temporary indwelling bladder catheter; simple [eg, Foley]), and 51703 (... complicated [eg, altered anatomy, fractured catheter/balloon]) into the following new HCPCS codes:

• G0428 -- Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex)
• G0429 -- Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (LDS) (e.g., as a result of highly active antiretroviral therapy)
• G0440 -- Application of tissue cultured allogeneic skin substitute or dermal substitute; for use on lower limb, includes the site preparation and debridement if performed; first 25 sq cm or less
• C9800 -- Dermal injection procedure(s) for facial lipodystrophy syndrome (LDS) and provision of radiesse or sculptra dermal filler, including all items and supplies.

CCI marks these bundles with modifier indicator "1," which indicates that you can report the two codes separately, when appropriate, by appending a modifier to the column 2 code, says Maggie M. Mac, CPC, CEMC, CHC, CMM, ICCE, Director of Network Oversight at Mount Sinai Medical Center Compliance Department in New York City.

Adopt Several New 58240 Edits

Per CCI 17.2, 58240 (Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof) now bundles all of the following codes:

• Lymphadenectomy codes 38564, 38571, 38572, 38770, and 38780
• Ureterectomy/ureterostomy codes 50650 and 50860
• Prostatectomy codes 55821, 55831, 55840, 55842, 55845, and 55866.

All these edits have a modifier indicator of "0." A modifier indicator of "0" means that you cannot break the bundle between these codes under any circumstance, Mac explains.

Urogynecology Coders Pay Attention to Enterocele Bundles

CCI 17.2 now bundles 57270 (Repair of enterocele, abdominal approach [separate procedure]) with vaginal hysterectomy with an enterocele repair codes 58270 (Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele), 58280 (Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele), 58292 (Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube[s] and/or ovary[s], with repair of enterocele), and 58294 (Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele).

These edits have a modifier indicator of "0."

You'll also find that now 51597 (Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof) bundles lymphatic resection codes 38562 - 38564, 38571-38572, 38572, 38770 and 38780, as well as ureterostomy code 50860, and prostatectomy codes 55821, 55831, 55840, 55842, 55845 and 55866. These also all carry a modifier indicator of "0."