Urology Coding Alert

Question: Can you help me code a cystoscopic laser incision of the bladder neck (for an anastomotic stricture) and hemoclip extraction in a patient who had a previous radical prostatectomy? Georgia Subscriber Answer: Report 52276 (Cystourethroscopy with direct vision internal urethrotomy) for internal urethrostomy of a stricture. Since a surgeon removed the bladder neck during the previous radical prostatectomy, the stricture is located at the anastomosis of the urethra and the bladder, not at the bladder neck as often reported. Because of this, 52276 would be the most appropriate code. The Correct Coding Initiative (CCI) bundles 52310 (Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder [separate procedure]; simple) and 52315 (... complicated) into 52276 and you cannot override the edit with any modifier. ICD-9 solution: The diagnosis for this case is 598.2 (Postoperative urethral stricture) since the stricture occurred after the radical prostatectomy.