Urology Coding Alert

Ensure that you know what they mean by each term.

The extent of treatment of prostate gland obstruction is often difficult to determine when the urologist starts to use the terms "partial" or "complete" because these terms have different meanings to different urologists. Also, many times the only obstructive anatomy of the prostate is a large middle or median lobe with minimal overgrowth of the lateral and anterior lobes and the removal of the median lobe alone adequately removes the obstructive part of the prostate.

Solution: Do not bill based on the amount of prostatic tissue removed by the endoscopic prostatectomy, says Michael A. Ferragamo MD, FACS, clinical assistant professor of urology, State University of New York, University Hospital and Medical School, Stony Brook, NY. Remember, we also do not have procedure codes to describe a partial or full endoscopic prostatectomy. In general, in these instances bill for the full endoscopic laser prostatectomy or TURP. In rare scenarios, you may add modifier 52 (Reduced services) to indicate the incomplete nature of the procedure.