Urology Coding Alert

Question: A patient underwent a TURP and then 60 days later (during the global period) returned for a post void residual urine determination. Would this study be included in the postoperative timeframe or could it be billed?

Mississippi Subscriber

Answer: The global package only includes services related to the original procedure (when the original procedure has a global day assignment). The TURP procedure code 52601 (Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included]) has a 90-day global period. The post void residual determination, 51798 (Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging), does not have a global. As a radiological study the global concept does not apply to 51798, and therefore, it is exempt from global period rules.

Remember: According to global surgery guidelines, diagnostic procedures and tests are not part of the global surgery package. Code 51798 falls into that category since it has a PC/TC indicator of "3," so you should be able to bill it in addition to the TURP.