Urology Coding Alert

READER QUESTIONS:

Anatomy Matters for Washing Codes

Published on Tue Jan 13, 2009

Question: My urologist performed a cystoscopy with bilateral kidney (renal pelvis) washings and bladder washings. I know the code for the bladder washing is 52005, but what would I use for the kidney washings?

Ohio Subscriber

Answer: Ideally, you would report 52005 (Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography,exclusive of radiological service) for washings from the kidney pelvis and ureters, and use 51700 (Bladder irrigation, simple, lavage and/or installation) for bladder washings.

Bad news: Unfortunately, the Correct Coding Initiative (CCI) bundles the latter code into the former code. Since this bundle has a modifier indicator of "0," you cannot use a modifier to override the edit in any circumstance -- you will not be able to report both codes.

Solution: Therefore, for Medicare in this scenario,you should only bill 52005 whether the washing are unilateral or bilateral. For private carriers you may need to report 52005-LT (Left side) and 52005-50-RT (Bilateral procedure, right side) for the bilateral washings of the upper tracts.

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