Urology Coding Alert
Pinpoint Pre-Op Ureteral Stent Placement Diagnosis
Question: My physicians frequently get asked to place stents for ureteral identification when patients are having other surgeries. Gastroenterology (GI) and gynecology (GYN) are the most common. When I bill them, there’s usually not a genitourinary (GU) diagnosis, so I’ve been using the preop code, Z01.818 (Encounter for other preprocedural examination), and the diagnosis for whatever surgery they’re having such as “GI cancer,” for example. As far as I know it’s getting paid, and the documentation backs what I’m using, but I can’t help but wonder if there’s a more appropriate coding. Do you have any advice? AAPC Forum Subscriber Answer: Remember, for preoperative ureteral stents, report 52005 (Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service) for bilateral ureteral catheters, not stents for Medicare and 52005-50 (Bilateral procedure) for non-Medicare payers. For diagnoses if you find pathology, report that pathology such as with codes N13.39 (Other hydronephrosis) or N13.4 (Hydroureter). If the study is normal, report the diagnosis of the surgeon. If your carrier will not pay for the above diagnoses because these are not urological diagnoses, then report codes Z40.8 (Encounter for other prophylactic surgery), N13.39 and Z46.6 (Encounter for fitting and adjustment of urinary device).
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Pinpoint Pre-Op Ureteral Stent Placement Diagnosis
Question: My physicians frequently get asked to place stents for ureteral identification when patients are having [...]
