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Urology Coding Alert

Reader Question:

Cystourethroscopy and Stent

Published on Sun Jul 01, 2001

Question: Our claim check software makes 52332 (cystourethroscopy, with insertion of indwelling ureteral stent [e.g., Gibbons or double-J type]) the primary procedure and 52353 (cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy [ureteral catheterization is included]) the secondary procedure, even though the payment for 52353 is more. How should I handle this?

Wisconsin Subscriber
 
Answer: You must call attention to where you perform the procedure. If its in your office, the insurance company will pay you more for placing the stent, because it will pay you for the stent as well. For example, if you did this for Medicare in New York and placed the stent in your office, you would be paid $1,172, and $393 for the ureteroscopy. But if you did the procedures in the hospital, you would be paid $202 for the stent placement and $393 for the ureteroscopy. Thats a big difference. In all likelihood, your carrier is not looking at where the procedure was done.
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