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Urology Coding Alert

Pelvic Pouch Procedure Proves Prickly

Published on Fri Jan 02, 2004

Question: My urologist did an endoscopic examination (cystoscopy) of a continent abdominal intestinal-urinary pouch via the contiguous intact urethra (urethra-intestinal continent diversion). How should I code this? This patient is insured under Medicare.
      
Indiana Subscriber

Answer: For this endoscopy, you should report the following codes:

 

  • CPT 44385 (Endoscopic evaluation of small intestinal [abdominal or pelvic] pouch; diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]) for the endoscopy of the abdominal intestinal diversionary pouch.

     
  • CPT 52000-52 (Cystourethroscopy [separate procedure]) for the endoscopy of the urethra.

    Append modifier -52 (Reduced services) to indicate that you only examined the urethra and no other structure such as the bladder.
     
    You can use the above coding for either Medicare or commercial carriers.

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