Urology Coding Alert

Tip: You can override most of these edits with a modifier

Code 50250 (Ablation, open, one or more renal mass lesion[s], cryosurgical, including intraoperative ultrasound, if performed) is bundled into column 1 CPT Codes 50220-50240 (Nephrectomy ...), including several simple, radical and partial nephroureterectomy codes.

Also bundled into cryoablation code 50250 are 43653, 44820, 44850, 49000-49010, 50040, 50045, 50100, 50541-50542, 50544, 50592, 50715 and 0135T. The modifier indicator for these edits is “1.”

Stent removal/replacement codes 50382-50387 are now bundled into codes 50575 (Renal endoscopy ... with endopyelotomy [includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertion of endopyelotomy stent]), 50605 (Ureterotomy for insertion of indwelling stent, all types) and 50947 (Laparoscopic ureteroneocystostomy). These edits have a modifier indicator of “1.”

Laparoscopic ablation of renal mass lesion(s) code 50542 now includes HCPCS code 0135T (Ablation, renal tumor[s], unilateral, percutaneous, cryotherapy). The modifier indicator for this edit pair is “1.”

Code 50592 (Renal tumor ablation by radiofrequency) is bundled into laparoscopic ablation codes 50541 and 50542. Code 50592 also includes certain fluoroscopy codes (76000, 76001), ultrasonic guidance codes (76942, 76998), radiologic guidance codes (77002, 77012), and category III code 0135T. The modifier indicator for these edits is “1.”

Category III code 0137T (Biopsy, prostate, needle, saturation sampling for prostate mapping) includes 55700 (Biopsy, prostate; needle or punch, single or multiple, any approach). The modifier indicator for this edit is “0.”