Urology Coding Alert

Question: My urologist performed a cystolitholapaxy for a stone sized greater than 2.5cm. They also performed a channel TURP and a bilateral retrograde pyelogram. According to the medical documentation, a bladder stone was attached to the bladder mucosa and the circumferential fashion around the bladder neck. My urologist removed all visible stones and then performed a channel transurethral resection of the prostate (TURP) to remove the mucosa that the bladder stone was attached to. They could see a stone growing through the wall of the bladder neck and prostatic base mucosa. My urologist performed a superficial resection of the mucosa at the bladder neck and of the mucosa of the prostatic base to remove all of the stone. My colleague believes we should report this as 52234, but I don’t agree. The is not a tumor; it is a stone. I feel that 52318 address the bladder stone, but I am not sure what to report for the channel TURP. Can you help me?

Answer: You should report the following codes:

• 52500 (Transurethral resection of bladder neck (separate procedure)) because it appears that the resection was only at the bladder neck,
• 52310 (Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple) for the removal of the stone