Urology Coding Alert

Question: When we have a patient that needs a stent change, the Pennsylvania Medical Society told me that I should report CPT 52352 for the removal of the stent and then 52332 with modifier 51 (Multiple procedures) for the placement of the stent. Is this correct?

Pennsylvania Subscriber

Answer: No, this is not correct. CPT, AMA and Correct Coding Initiative (CCI) all indicate that in a replacement of a prosthesis or other artificial implant or device, coding guidelines do not allow you to separately report the removal of the old device with the replacement of a new device.

The correct code for the removal of a stent from the bladder is 52310 (Cystourethroscopy, with removal of foreign body, calculus. or ureteral stent from urethra or bladder [separate procedure]; simple). Code 52352 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus ...) is for ureteroscopic ureteral stone extraction, and, therefore, is not the correct code for removal of a stent from the bladder. Code 52332 (Cystourethroscopy, with insertion of indwelling ureteral stent ...) includes 52310, and you cannot bypass this CCI bundle with any modifier. Therefore, the coding for stent removal and replacement for Medicare and most private carriers should be 52332 alone.