Urology Coding Alert

Question: The doctor performed a cystourethroscopy with bladder biopsies (52204) for carcinoma of the bladder, then obtained prostate biopsies with the resectoscope. The doctor thinks we should code for a partial TURP (52601). How should this be coded?

Roseann Lightbody, Charlotte, N.C.

Answer: Code the biopsies with resectoscope as 52601 (transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included]), but if the procedure was not complete as far as resection of the prostate is concerned, use modifier -52 to show reduced services.

Another option is to add modifier -22 (unusual services) to the bladder biopsy code. In this procedure, the resectoscope is passed up the urethra to the prostate and specimens are obtained. The bladder biopsies are collected through the same scope. If the physician feels that a significant amount of additional time is necessary, physician work and increase risk to the patient are involved, than an increase in reimbursement is to be expected.