Urology Coding Alert
Use 2 Codes for Multiple Fulgurations
Question: One of our patients had a vesicovaginal fistula. The op report reads: Cystoscopy was performed, fistula was identified. Guidewire passed through the fistulous tract and then re-examined from the vaginal wall side. Fistulous tract was then cauterized with electrocautery. The physician then repeated the cystoscopic examination and used the Bugbee cautery to cauterize the fistulous tract from the bladder side. What codes should we use? Kansas Subscriber Answer: First, report 52214 (Cystourethroscopy, with fulguration [including cryosurgery or laser surgery] of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands) for the fulguration within the bladder. Then, report 57061 (Destruction of vaginal lesion[s]; simple [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery) for the fulguration within the vagina. Take note: Payers will consider the catheter placement and the guidewire passage to be part of the procedure, so there is no separate billing for these.
Urology Coding Alert
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