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Urology Coding Alert

READER QUESTIONS:

Bilateral Status Depends on the Payer

Published on Tue Jan 13, 2009

Question: When an urologist performs bilateral retrogrades is it allowable to bill CPT 52005 -RT and 52005- LT? I know we can't use modifier 50, and the description says ureteral catheterization, but nothing is plural in the description. Ohio Subscriber Answer: When you are billing Medicare, you use CPT code 52005 (Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiological service) for both unilateral and bilateral retrograde studies. Alternative: For private or commercial payers, you can code as you suggested, using either 52005-LT (Left side) and 52005-50-RT (Bilateral procedure; right side). Some non-Medicare insurance companies will pay you for each side when you bill for the bilateral studies.
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