Urology Coding Alert
Determine Codes Radiotherapist Is Reporting
Florida Subscriber
Answer: If the radiotherapist is performing the complete procedure and seed implantation without the help of the urologist, you most likely won't be able to report the cystoscopy.
You need to determine if the radiotherapist is billing 55859 (Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy) with the other services he's reporting. If he is, you'll have a problem getting payment for a cystoscopy. This is because code 55859 also includes a cystoscopy and seed removal, as determined by the American Urological Association.
If the radiotherapist does not include code 55859 in his billing for the seed implantation, however, you should be able to report and be reimbursed for a cystoscopic examination. You should report 52000 (Cystourethroscopy [separate procedure]) for this service.
Bonus: If the urologist performed the procedure to remove a displaced seed, you could also report 52310 (Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder [separate procedure]; simple).
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