Urology Coding Alert
Not Everybody Must Get Stones
A repeat ultrasound failed to reveal any evidence of a kidney stone. Repeat fluoroscopy failed to reveal a calcified stone in the kidney area. Because there was no evidence of a stone visible on ultrasound or fluoro-scopy, the ESWL was not performed. Should I bill only for the fluoroscopy?
Minnesota Subscriber
Answer: You can't bill for the ESWL (50590, Lithotripsy, extracorporeal shock wave) or even use modifier -53 (Discontinued procedure) because the ESWL wasn't started.
Report 76000 (Fluoroscopy [separate procedure], up to one hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]) for the fluoroscopy and 76775 (Ultrasound, retroperitoneal [e.g., renal, aorta, nodes], B-scan and/or real time with image documentation; limited) for the renal sonogram and also append modifier -26 (Professional component) if the procedures were performed in the hospital.
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