West Virginia Subscriber
Answer: You should use 52240 (Cystourethroscopy, with fulguration [including cryosurgery or laser surgery] and/or resection of; large bladder tumor[s]) to report this procedure. Because the code descriptor for the transurethral resection (TUR) of bladder tumors procedure specifies fulguration and/or resection, this is the appropriate code.
For a TUR of a bladder tumor, you report 52234 (Cystourethroscopy, with fulguration [including cryosurgery or laser surgery] and/or resection of; small bladder tumor[s] [0.5 up to 2.0 cm]), 52235 (Cystourethroscopy, with fulguration [including cryosurgery or laser surgery] and/or resection of; medium bladder tumor[s] [2.0 to 5.0 cm]), or 52240 based on the size of the tumor. In this case, since the urologist fulgurated over half the patient's bladder, 52240 is the best choice.
Report ICD-9 code 233.7 (Carcinoma in situ of breast and genitourinary system; bladder) as well.
Caution: Any biopsies of the tumor that your urologist may perform are included in the treatment and fulguration, so you cannot separately report them.