Urology Coding Alert

Question: My urologist has performed the following procedure:

·         Ureteroscopic dilatation/laser incision of an infundibular stricture to drain a calyceal diverticulum

·         Ureteroscopic laser lithotripsy of a right renal calculus

·         Right double- J stent placement

I know the codes for the lithotripsy and the stent but I can’t find anything for the dilatation/laser incision. Can you help? Do I need to use an unlisted code, and if yes, what other code would I use to mirror the reimbursement?

Massachusetts Subscriber

Answer: You should report 52346 (Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture [eg. balloon dilation, laser, electrocautery, and incision]) for the laser incision of an intra-renal infundibular stricture.

Code this scenario the following way:

·         52346 for the laser incision of the infundibulum. Attach ICD-9 code 593.89 (Other specified disorders of kidney and ureter) [ICD-10 code: N28.89, Other specified disorders of kidney and ureter]

·         52353 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy [ureteral catheterization is included]) for the laser lithotripsy of the renal calculus. Attach ICD-9 code 592.0 (Calculus of kidney) [ICD-10 code: N20.0, Calculus of kidney, or N20.2, Calculus of kidney with calculus of ureter]

·         52332 (Cystourethroscopy, with insertion of indwelling ureteral stent [eg, Gibbons or double-J type]) for the double J stent placement with 592.0.