Urology Coding Alert

Reader Question:

Don't Count on Exact Wording in Code Descriptors

Question: How should I code the removal of a stent that has migrated into the ureter? CPT 52310 does not include the ureters.

Alabama Subscriber


Answer:
There isn't a code that exactly specifies foreign body removal from the ureters. But experts recommend reporting 52351 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic) with modifier 22 (Unusual procedural services) when a urologist performs a cystourethroscopy and ureteroscopy to remove a stent that has migrated up the ureter and whose distal J coil is not visible in the bladder.

Add modifier 22 to indicate the extra work of grasping the intra-ureteral stent and its subsequent removal.

Warning: Do not bill 52352 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus ...) because this code represents the removal of a ureteral stone, not a foreign body or stent.

Diagnosis help: Use 939.9 (Foreign body in genitourinary tract; unspecified site) for the stent, which is a foreign body, in the ureter.

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