Urology Coding Alert

Question: Can I bill 51700 during the post-operative period of a TURP without a modifier?

Louisiana Subscriber

Answer: The answer depends on the details of the clinical scenario and the payer to which you are billing. 

If you are irrigating clots from the bladder after a transurethral resection of prostate (TURP), and the urologist is performing the procedure during the global period of the TURP, consider this a treatment of a complication of the TURP.  

For Medicare, when performed in the office, this procedure is not a billable service. However, for most, but not all non-Medicare payers, the treatment of a complication in the office is a billable service. For a non-Medicare patient irrigation in the office may be paid. Use code 51700 (Bladder irrigation, simple, lavage and/or instillation) with modifier 79 (Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period) attached if this occurs within the global period.

If your urologist returns the patient to the hospital operating room and performs the irrigation in the OR, then you can bill the service to both Medicare and other payers. Report 51700 and attach modifier 78 (Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period).