Urology Coding Alert

Reader Question:

189.3 vs. 223.81 Depends on Pathology

Question: What ICD-9 Code should I use when the doctor documents "tumor of the urothelium of the prostatic urethra"? Florida Subscriber Answer: If the tumor is malignant you should use 189.3 (Malignant neoplasm of kidney and other and unspecified urinary organs: urethra). However, if benign, use 223.81 (Benign neoplasm of urethra) instead. Alternative: For a polyp of the urethra, use 600.20 (Benign localized hyperplasia of prostate without urinary obstruction and other lower urinary tract symptoms [LUTS]) or 600.21 (... with urinary obstruction and other lower urinary tract symptoms [LUTS]). If you don't know the pathology of the tumor and are billing before you have the pathology report, you should use 239.5 (Neoplasms of unspecified nature; other genitourinary organs) to indicate the pending pathology.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Urology Coding Alert

View All

Which Codify by AAPC tool is right for you?

Call 844-334-2816 to speak with a Codify by AAPC specialist now.