Urology Coding Alert

Question: My urologist is performing a new procedure called a "button TURP." I thought CPT 52601 or CPT 53852 might be correct, but now I'm thinking an unlisted procedure code may be more appropriate. What code should I use for this procedure?

California Subscriber

Answer: You should report 52601 (Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included]) for the button transurethral resection of the prostate (TURP) procedure.

Why: The button TURP is a bipolar electrical vaporization of the prostatic adenoma with a buttonappearing electrode. Several years ago there was another procedure using a ball type electrode to electrically vaporize the prostate. This instrument was called a Vaportrobe. At that time, coders were instructed to bill for the Vaportrobe using 52601 as this was an electrical procedure. Likewise, you should now use 52601 for a "button TURP."

Pitfall: While the button TURP procedure resembles a laser treatment, it is not a laser vaporization. Therefore, you should not use 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]) or 52649 (Laser enucleation of the prostate with morcellation, 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]). Also remember that this procedure is not radiofrequency thermotherapy, therefore, 53852 (Transurethral destruction of prostate tissue; by radiofrequency thermotherapy) is not the appropriate code to report either.