Urology Coding Alert
Remember That 52356 Includes the Work of 52351
Question: The surgeon completed cystoscopy and right ureteroscopy with laser lithotripsy and stone basketing with stent placement. Two coders in our office disagree on the correct way to report this service; one says 52356 and the other says 52356 with 52351. What do you recommend? New Hampshire Subscriber Answer: The correct answer is to submit only 52356 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)). NCCI edits bundle 52351 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic) into 52356. The edits do not permit you to append a modifier to override the edit, so you cannot report both procedures on the same claim.
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