Urology Coding Alert

Question: When I do a cystoscopy and a retrograde pyelogram at the hospital, who bills for interpretation of the x-ray, the radiologist or the urologist? What code should I use to bill for interpretation of the x-rays Ive just performed? What code do I use for the performance of the procedure?

Kansas Subscriber

Answer: Use 52005 (cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service) for the procedure, and 74420 (urography, retrograde, with or without KUB) with modifier -26 (professional component) for the professional fee for radiology interpretation done in the hospital. Note that a separate radiology report must be made in addition to satisfy criteria for payment for this radiology service.

Usually this matter boils down to hospital policy. If there is an agreement between the hospital and the radiologist that the radiologist provides interpretations of all hard-copy films, the radiologist will bill. Of course, if you get your charge in first you may get the payment, but this may cause hard feelings between the hospital and/or radiologists and the urologist. The bottom line is you may not be able to bill for intraoperative radiological pro-cedures performed at that particular hospital.