Urology Coding Alert

Question: Can a physician report the following CPT^® codes: 52352, 52353, 52356, and 52648 in a POS 11 - Office Setting?

AAPC Forum Member

Answer: A physician can only code for 52352 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)), 52353 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)), 52356 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)) and bill them when performed in a facility such as a hospital or ambulatory surgical center (ASC), but not in an office.

The fee schedule for these codes is limited only for facility payments. Code 52648 (Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)) may be performed in a facility, hospital, or ASC, as well as in an office (Place of Service, POS 11) setting. The fee schedule for 52648 includes fees for both in-hospital and in-office POS 11 settings. Payments for 52648 are made whether the procedure is performed in a facility or non-facility.