Urology Coding Alert

5 questions to put your knowledge of CPT 2005 and NCCI 11.0 to the test

Still trying to digest all the changes from CPT 2005 and NCCI version 11.0? This quiz will help you determine whether you're on the right track with the new codes and bundles.

Hint: You can find all the quiz answers in one of these three past Urology Coding Alert articles: "CPT Codes 2005 Update: Ring In the New Year With 3 New Fournier's Debridement Codes" from the November 2004 issue, "Coding 96400 for Lupron Administration? Not Anymore" from the January 2005 issue, or "NCCI Edits 11.0 Update: Include Nerve Blocks and Venipuncture in New Fournier's Debridement Codes" from the February  2005 issue.

Question 1: Which CPT code should you report to Medicare for Zoladex injections in 2005?

A. 90782
B. 96400
C. G0351
D. G0356
E. G0001

Question 2: A urologist transplants a kidney from a cadaver donor, after preparing it on the back table by removing perinephric fat and preparing the veins, arteries and ureters. Which code(s) should you report?

A. 50300
B. 50323
C. Both 50300 and 50323
D. None of the above

Question 3: A cancer patient has only one kidney. Instead of performing a nephroureterectomy, the urologist infuses BCG through a catheter into the upper urinary tract to attempt to destroy the cancer threatening the remaining kidney. Which CPT code is appropriate?

A. 50391
B. 51700
C. 51720
D. G0356

Question 4: Which of the following CPT codes is not considered an integral part of the new Fournier's debridement codes (11004, 11005 and 11006), according to the National Correct Coding Initiative?

A. 37202
B. 62318
C. 64450
D. All of the above
E. None of the above

Question 5: NCCI considers CPT code 50684 a component of which comprehensive procedure?

A. 50572
B. 50961
C. 52007
D. All of the above
E. None of the above

Answer 1: D. Medicare directs coders to report code G0356 (Hormonal antineoplastic) instead of 96400 (Chemotherapy administration, subcutaneous or intramuscular, with or without local anesthesia) in 2005 for Zoladex injections, as well as for Lupron and other anti-neoplastics.
 
For therapeutic or diagnostic injections such as Depo-Testosterone, report G0351 (Therapeutic or diagnostic injection; subcutaneous or intramuscular) instead of 90782 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular). Medicare deleted G0001 (Routine venipuncture for collection of specimen[s]) for 2005. In its place, use code 36415 (Collection of venous blood by venipuncture).

Answer 2: C. You may report transplant code 50300 (Donor nephrectomy; from cadaver donor, unilateral or bilateral) along with preparation code 50323 (Backbench standard preparation of cadaver donor renal allograft prior to transplantation ...).

Answer 3: A. Report this topical immunotherapy procedure with 50391 (Instillation[s] of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube), a new code in CPT 2005.

Answer 4: E. None of these codes - 37202 (Transcatheter therapy, infusion other than for thrombolysis, any type), 62318 (Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast, of diagnostic or therapeutic substance[s], epidural or subarachnoid; cervical or thoracic) or 64450 (Injection, anesthetic agent; other peripheral nerve or branch) - are separate from 11004 (Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum), 11005 (... abdominal wall, with or without fascial closure) and 11006 (... external genitalia, perineum and abdominal wall, with or without fascial closure). The codes are all bundled by NCCI version 11.0.

Answer 5: D. All of the codes - 50572 (Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter), 50961 (Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus) and 52007 (Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis) - include 50684 (Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter). The codes are bundled by NCCI version 11.0.

 - Answers reviewed by Morgan Hause, CCS,  CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 31-urologist practice in Indianapolis.