Advanced Search

Urology Coding Alert

Reader Question:

Cystourethroscopy and ESWL

Published on Mon Apr 01, 2002

Question: Should I report CPT 50590 and CPT 52005 together? The physicians feel that these are separate procedures.

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.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Urology Coding Alert

View All