Urology Coding Alert
Don't Miss the Proper Diagnosis When the Pathology Report Indicates Associated Diagnoses
Question: The urologist performed an open radical cystectomy with a radical prostatectomy for a patient with bladder cancer. The prostate pathology report stated, “acute prostatitis and granulomathous prostatitis.” I expect to file 55840 for the procedure but am unsure of the best diagnosis. What do you recommend?
North Carolina Subscriber
Answer: You’re correct in submitting 55840 (Prostatectomy, retropubic radical, with or without nerve sparing) for the radical prostatectomy along with the cystectomy code.
The diagnostic codes indicating the reason for the radical prostatectomy should be either C61 (Malignant neoplasm of prostate), D49.5 (Neoplasm of unspecified behavior of other genitourinary organs), or C79.82 (Secondary malignant neoplasm of genital organs). These latter conditions are often found in the prostate gland associated with bladder carcinoma, and they constitute the reasons for removal of the prostate gland along with the cystectomy for bladder neoplasm.
Note: The radical cystoprostatectomy is the gold standard treatment for invasive bladder cancer.
You can submit the two diagnoses N41.0 (Acute prostatitis) and N41.4 (Granulomatous prostatitis) based on the pathology report as associated diagnoses. Remember that the latter diagnoses do not represent indications (reasons) for the radical prostatectomy and alone would not allow payment for this procedure.
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