Urology Coding Alert
Append Modifier 52 When Full Procedure Isn't Performed
Question: The patient’s Mitrofanoff stoma stenosed near the bladder end of the stoma. Our physician removed the stoma from the stenosed site, found another area of the bladder, and performed a re-anastomosis there. What’s your suggestion for proper coding of this procedure? South Dakota Subscriber Answer: Based on the information you share, think of this as a bowl revision to be a partial redo of the procedure in question. In this case, code 50845 (Cutaneous appendico-vesicostomy) is likely the best code to use. You’ll want to append modifier 52 (Reduced services) to indicate that the urologist did only a portion of the full procedure represented by 50845 and not the full Mitrofanoff procedure. Plus: Include a detailed operative report and an explanatory cover letter in layman’s terms that explains what the physician actually did to help move the claim through the reimbursement process with fewer complications.
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Append Modifier 52 When Full Procedure Isn't Performed
Question: The patient’s Mitrofanoff stoma stenosed near the bladder end of the stoma. Our physician [...]
