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Urology Coding Alert

Reader Question:

55899: Remember to Benchmark to Existing Codes When Using Unlisted CPT® Codes

Published on Fri Jun 17, 2011

Question: The doctor did a laparoscopic robotic assisted suprapubic prostatectomy for BPH with obstruction and removal of bladder calculus. What code should I use for the SP prostatectomy? The only lap prostatectomy code is 55866, and there isn't an unlisted lap code. Should I bill 55866 with a reduced services modifier? Would the removal of the bladder stones be bundled with the prostatectomy?South Carolina SubscriberAnswer: You should report this surgery using unlisted code 55899 (Unlisted procedure, male genital system). Benchmark your payment using the similar open procedure codes 55821 (Prostatectomy [including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy]; suprapubic, subtotal, 1 or 2 stages) and the open suprapubic stone removal code, 51050 (Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection).
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