Urology Coding Alert

Question: A patient has a history of bladder cancer and had a previous resection of a bladder tumor. The urologist performed cystoscopy and discovered edema from the previous resection and two areas that did not appear completely healed. Necrotic debris was persistent on the bladder wall. He used bugbee cautery to remove the necrotic debris and cauterized those sites. Would code 52224 be appropriate to report?

Tennessee Subscriber

Answer: Code 52224 (Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy) is a possibility, but remember that the codes from this family are based on the lesion size. Read through the medical record to determine the size and choose your code accordingly:

• 52224
• 52234 – Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm)
• 52235 – … MEDIUM bladder tumor(s) (2.0 to 5.0 cm)
• 52240 – … LARGE bladder tumor(s).