Urology Coding Alert
Cystourethroscopy and ESWL
Ohio Subscriber
Answer: Code 52005 (Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service) is bundled into 50590 (Lithotripsy, extracorporeal shock wave) (ESWL). However, under the proper clinical circumstances, the bundle can be broken using several different modifiers, such as -59 (Distinct procedural service), -78 (Return to the operating room for a related procedure during the postoperative period) and -79 (Unrelated procedure or service by the same physician during the postoperative period).
If a ureteral catheter is placed before ESWL and then removed, this is not a billable service.
If a retrograde pyelogram is performed for a suspected stone in the contralateral ureter, bill 52005-59 and 74420-26 (Urography, retrograde, with or without KUB, professional component). The retrograde procedure then becomes a distinct, independent procedure evaluating the contralateral urinary tract.
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