Urology Coding Alert

Question: Would the CPT code be any different for indigo laser treatment of bladder neck contracture versus prostate? My doctor is also using the indigo laser for blasting bladder stones. How should I report that too?


Delaware Subscriber

Answer: You should report 52450 (Transurethral incision of prostate) for a laser incision of a bladder neck and append modifier 52 (Reduced services). Code 52450 represents an incision of the prostatic urethra usually extending from and including the bladder neck to the verumontanum, the complete prostatic urethra, but adding modifier 52 indicates a reduced service, in this case an incision only at the bladder neck. You can use this code and modifier for any number of incisions at the bladder neck using any technology, such as a hot or cold knife, or laser incision as referred to here.

For the fragmentation of bladder calculi, you would report either code 52317 (Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small [less than 2.5 cm]) or code 52318 (... complicated or large [over 2.5 cm]) depending on the stone size and/or multiple calculi fragmented.