Urology Coding Alert

Question: I need help coding this case. If the provider used #2.5 French laser fiber pulse to break the ureteral stone, is this lithotripsy or calculus destruction by ultrasonic or electro-hydraulic?

AAPC Forum Participant

Answer: Although you need more information regarding the procedure to answer this question fully, you should know that calculi can be destroyed by different techniques — ultrasound, laser, or electro-hydraulic (EHL) means. Ultrasound uses sound waves to destroy the stones and lasers can also be used to destroy stones.

“If the ureteral stone was fragmented through a ureteroscopy with the laser fiber, then you should use 52353 [Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)]. CPT^® code 52325 [Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)] describes stone destruction by ultrasound or electro-hydraulic means through a cystourethroscope. The difference in these two codes are simply the means by which the calculi were destroyed — either using cystourethroscopy or cystourethroscopy with ureteroscopy,” says Stephanie Storck, CPC, CPMA, CUC, CCS-P, ACS-UR, longtime urology coding expert and consultant in Glen Burnie, Maryland.