Urology Coding Alert

Question: Can we bill for 51700 if it was completed during the global period following 52649? If so, do we need to append either modifier 58 or 78?

New Hampshire Subscriber

Answer: No, you cannot report 51700 (Bladder irrigation, simple, lavage and/or instillation) in these circumstances, even with modifier 58 (Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period) or 78 (Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period).

Here’s why: According to the most recent Correct Coding Initiative edits, code 51700 is considered a Column 2 code for 52649 (Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)) and bundled into 52649. This edit has a bundling indicator of “0” meaning no modifiers are available to undo this edit. Hence, you are not allowed to bill the two procedures together under any circumstances, even when the irrigation occurs during the global period.