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Urology Coding Alert

News Brief:

Carriers Make Own Bundling Edits for Ureteroscopy Codes

Published on Sun Jul 01, 2001

New ureteroscopy codes were introduced in 2001, but in the most recent Correct Coding Initiative (CCI) edits, version 7.1, the codes were not bundled as they had been in version 6.3. This led many coders to believe they could bill ureteroscopy codes together. However, many carriers are using the old CCI version 6.3 guidelines for ureteroscopy codes. They wont reimburse for the ureteroscopy codes when billed together. 

Some carriers, like Empire in New York, are going back to the CCI rules of version 6.3 (for the ureteroscopy codes, not for any other codes). These edits resemble the old black box edits because nobody knows what they are. The carrier has transferred the old bundling process from 6.3 into the new ureteroscopy codes because it appears that Medicare made a mistake by forgetting to include the bundles.

If you code according to the intent of CCI (see Urology Coding Alert May 2001 issue, New Ureteroscopic Codes Not Bundled in CCI Version 7.1), you will not bill ureteroscopy codes with each other or with a stent (52332). The old codes allowed unbundling of the stent using modifier -59 (distinct procedural service).
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