Urology Coding Alert

Question: A newcomer to urology coding, I am having a difficult time finding two laser codes: one for laser vaporization of the prostate and another for laser lithotripsy. Do you have any suggestions? Pennsylvania Subscriber Answer: When code definitions don't perfectly mirror your operative report procedure descriptions, choosing CPT codes can be a real hassle.

Your first step is to choose a laser vaporization code depending on the type of laser that was used and documented by the physician, either a contact, such as an indigo laser, or a non-contact laser. Contact laser vaporization requires code 52648 (Contact laser vaporization with or without transurethral resection of prostate, including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included]), whereas non-contact laser vaporization requires 52647 (Non-contact laser coagulation of prostate, including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included]). If your urologist documents a specific type of laser, such as the indigo laser, and you are not sure if it is contact or non-contact, don't hesitate to ask your physician it will make all the difference when submitting your claim. Use code 52317 (Litholaplaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small [less than 2.5 cm]) or 52318 ( complicated or large [over 2.5 cm]) based on the size of the stone and/or if multiple stones require lithotripsy.