Urology Coding Alert

Question: The urologist performed a DaVinci robotic-assisted simple suprapubic prostatectomy. Would this still qualify for 55866 with a reduction modifier 52, as this was a simple instead of a radical prostatectomy? I do not see another code for robot-assisted, and I am hoping to not have to use an Unlisted Procedure code.

Utah Subscriber

Answer: Following the new coding guidelines for laparoscopic cystectomy noted in an earlier discussion in this issue and extending the rule to other laparoscopic procedures without specific CPT^® codes, report code 55821 (Prostatectomy [including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy] suprapubic, subtotal, 1 or 2 stages). Note that this code lacks an approach vignette in its descriptive code definition. In other words, you may use this code to bill either an open or laparoscopic simple suprapubic prostatectomy using only 55821. Adding modifier 52 to code 55866 (Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed) is incorrect coding as you cannot change a code description or meaning of a procedure code by adding modifier 52 (Reduced services).