Urology Coding Alert

The code has changed, but the bundles stay the same

Something peculiar happened with the urology Codes in January - the new CPT Manuals removed one cystourethroscopy code and introduced another one with the exact same description. We've got the scoop on what's going on.

CPT 2005 introduced 52402 (Cystourethroscopy with transurethral resection or incision of ejaculatory ducts) as a replacement for deleted code 52347, to move the procedure into the "Vesical Neck and Prostate" section of the CPT manual from the "Ureter and Pelvis" section, says Maureen Beckwith, CPC, analyst at the University of California at San Francisco Medical Center Urology Practice. Code 52402 packed up most of 52347's bundles when it moved; according to NCCI 11.0, 52402 includes:

 

 36000 - Introduction of needle or intracatheter, vein
 

 36410 - Venipuncture, age 3 years or older, necessitating physician's skill (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)
 

 37202 - Transcatheter therapy, infusion other than for thrombolysis, any type (e.g., spasmolytic, vasoconstrictive)
 

 52001 - Cystourethroscopy with irrigation and evacuation of multiple obstructing clots
 

 53080 - Drainage of perineal urinary extravasation; uncomplicated (separate procedure)
 

 Urethral dilation codes 53600-53665
 

 Diagnostic or therapeutic injection codes 62318-62319
 

 Nerve block injection codes 64415-64417 and 64450-64475.

These bundles retained their "1" modifier indicator, which indicates that you may use a modifier to report these codes with 52402 under the proper clinical circumstances. Code 52402 also includes:
 

 00910 - Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified
 

 00916 - ... post-transurethral resection bleeding
 

 Indwelling bladder catheter codes 51702-51703
 

 52000 - Cystourethroscopy (separate procedure)
 

 52010 - Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation or duct radiography, exclusive of radiologic service
 

 52281 - Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female
 

 Operating microscope code +69990
 

 P9612 - Catheterization for collection of specimen, single patient, all places of service.

NCCI assigns a status indicator of "0" to all of the above bundles, indicating that you may not report these codes together under any circumstances.