Urology Coding Alert

Hint: Pay attention to the payer you're coding for.

Coding transurethral bladder tumor removal (TURB) procedures -- especially when the urologist removes multiple tumors in one operative session -- challenges even veteran coders. Ensure that you understand how to handle on this complicated coding situation by taking this five-question quiz and then checking your answers against the expert answers on page 77.

Question 1: Your urologist transurethrally resects a 2 cm tumor and a 3 cm tumor. The patient has Medicare insurance. Which code(s) should you use to report your urologist's services?

Question 2: During one operative session, the urologist transurethrally resects a 3.5 cm bladder tumor and at the same time also resects a minor bladder tumor (less than 0.5 cm in size). How should you report this procedure to a private payer?

Question 3: The urologist transurethrally resects five 1 cm tumors at one sitting. Which code should you report and should you append modifier 22 (Increased procedural services) for the extra work of removing multiple tumors?

Question 4: Your urologist performs a transurethral biopsy of a bladder tumor before resecting it completely. Can you separately report both the biopsy and the tumor removal?