Urology Coding Alert

Question: I’m new to urology and really struggling with clarification for cystourethroscopy codes 52204, 52214, 52234, 52235, and 52240. Is 52204 just a cystourethroscopy with biopsy and no fulguration or is fulguration included? Is 52214 solely a cystourethroscopy with fulguration of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands or can this include a biopsy if it is needed for these specific areas? Is 52224 a cystourethroscopy with either fulguration or resection of a tumor, but not both with or without a biopsy? Also, why is the term “treatment” used here instead of resection like with the small, medium, and large tumor codes? Do codes 52234, 52235, and 52240 include biopsies if performed?

AAPC Forum Subscriber

Answer: You should code 52204 (Cystourethroscopy, with biopsy(s)) for a cystourethroscopy and one or multiple bladder or urethral biopsies. It also includes fulguration of a bleeder within the biopsy site. Code 52214 is used for fulguration but does not include a biopsy. Codes 52224, 52234, 52235, and 52240 are cystoscopic treatments of bladder tumors based upon size of the tumor. These codes include biopsy and take in all endoscopic modalities such as “treatment, fulguration, and resection” together or individually. You should bill only one time per treatment.