Urology Coding Alert
No ESWL Means No Reporting 50590
Question: A patient was scheduled for an ESWL in the ASC. She was brought into the operating room prior to anesthesia administration. Fluoroscopy and kidney ultrasound were carried out, but no stone was identified. Therefore, the procedure was canceled. What are we allowed to bill for the encounter? Vermont Subscriber Answer: According to the information you give, it would not be appropriate to bill code 50590 (Lithotripsy, extracorporeal shock wave) since the actual ESWL procedure did » not occur. Even appending modifier 53 (Discontinued procedure) would not be appropriate since modifier 53 applies in extenuating circumstances when the patient’s well-being is threatened. Neither of those circumstances applies in the case you describe. You should always report only the procedure(s) actually completed. In your situation, only report the renal sonography, 76775 (Ultrasound, retroperitoneal (eg. renal, aorta, nodes) real time with image documentation; limited).
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