Urology Coding Alert

Question: When our urologists perform a trans-urethral destruction of prostate by radiofrequency thermotherapy (TUNA), they administer Xylocaine jelly before doing the procedure. One of the doctors indicates that he uses the cystoscope to administer it and wondered why insurance keeps bundling the work. Can we bill for the medication (Xylocaine jelly) itself? And do we need to figure out units or time measured for the anesthesia with 00910?

Iowa Subscriber

Answer: Local, topical, or regional anesthesia administered by the physician performing the procedure is part of the global surgical package and is not separately billable. That would include the Xylocaine jelly that your physicians are using, which is why any code for that administration is being bundled: you cannot code for it separately.

Code 00910 (Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified, is only billable by an anesthesiologist and is for IV anesthesia.

The only code you can report for the urologist is the TUNA procedure itself. Submit 53852 (Transurethral destruction of prostate tissue; by radiofrequency thermotherapy) for that.