Urology Coding Alert

Question: A physician wanted to know if he could charge multiple units for CPT 50200 . I've read information that says 50200 includes several biopsy passes. To me, this says that I should only report 50200 once. Am I on the right track here?

Answer: You are correct. Code 50200 (Renal biopsy; percutaneous, by trocar or needle) includes as many biopsies as the physician obtains. Report this code once regardless of the number of biopsies.

Rarely, a urologist will biopsy a renal mass before deciding on its treatment. But this biopsy may lead to a particular procedure, such as a nephrectomy. When your urologist performs an open renal biopsy (50205, Renal biopsy; by surgical exposure of kidney), and a positive result leads the urologist to perform a radical nephrectomy, report these codes:

• 50230 (Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy) for the radical nephrectomy, and
  
• 50205-58 (Renal biopsy; by surgical exposure of kidney; staged or related procedure or service by the same physician during the postoperative period) for the kidney biopsy. In this case, modifier 58 breaks the bundle and indicates that the biopsy led to the subsequent surgical procedure.