Urology Coding Alert

Question: I read the article in Urology Coding Alert (2007, Vol. 10, No. 2) regarding the coding of robotic-assisted procedures. One of the urologists that I bill for does prostatectomies using the robotic system. But for most of these cases, he also does the bilateral pelvic lymphaden-ectomy using robotics. Since he uses the robot to take out the prostate and the lymph nodes, should I attach the S2900 to both 55866 and 38571 or just use it once?

Tennessee Subscriber

Answer: You should bill S2900 (Surgical techniques requiring use of robotic surgical systems [list separately in addition to code for primary procedure]) only once per operative session no matter how many robotic procedures the urologist performed during the same operative encounter.

Tip: Remember to use S2900 only for non-Medicare carriers (Medicare will not reimburse for S codes). When you report S2900 you do not need any modifiers because S2900 is an add-on code.

For this clinical scenario, you should first report 55866 (Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing) for the robotic-assisted radical prostatectomy. Then report 38571 (Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy) for the robotic-assisted bilateral pelvic lymphadenectomy.

Append modifier 51 (Multiple procedures) to 38571 because your urologist performed more than one procedure during the same operative session. Finally, report S2900 for the robotic technology the urologist used.