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Urology Coding Alert

Reader Question:

Total Urethrectomy

Published on Fri Jun 01, 2001

Question: The patient underwent a radical cystectomy for bladder cancer, with an ileal conduit diversion (51595). Six months later she was diagnosed with urethral carcinoma and had a total urethrectomy. How should I code this?

California Subscriber

Answer: For a female, code 53210 (urethrectomy, total, including cystostomy; female). For a male, code 53215 (... male). Because the procedure includes a suprapubic cystostomy in a patient whose bladder has been removed, you must add modifier -52 (reduced services) to whichever code you use. Send a paper claim and include an operative report. Be sure to include a note explaining the procedure exactly. Note that the urethrectomy is the major part of 53210 or 53215, and would constitute 80 percent of the full procedure. The payer will likely pay 75 percent of the full fee.
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