Urology Coding Alert

The latest CCI targets a large number of urology surgical codes With more than 10,000 changes, you could spend hours weeding through the latest round of Correct Coding Initiative (CCI) edits. But we've already done the deciphering for you. Take a look at the urology edits and deletions you need to incorporate into your coding this year. Code Just 1 Ablation Procedure CCI has bundled new code 50593 (Ablation, renal tumor[s], unilateral, percutaneous, cryotherapy) into open ablation code 50250 (Ablation, open, one or more renal mass lesion[s], cryosurgical, including intraoperative ultrasound, if performed) and laparoscopic ablation codes 50541 (Laparoscopy, surgical; ablation of renal cysts) and 50542 (... ablation of renal mass lesions[s]). These are mutually exclusive edits with a modifier indicator of 1, which means you can bypass the edit with a modifier under appropriate clinical circumstances. Reasoning: This edit makes sense because you wouldn't do a percutaneous ablation at the same time you would do an open or laparoscopic ablation, says Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 31-urologist, two-urogynecologist practice in Indianapolis. "They would probably be done in different settings, but never on the same day." Home In on HoLEP Edits CPT 2008 offers you a long-awaited code for the laser enucleation of the prostate technique followed by prostatic adenoma morcellation to remove it from the bladder -- or HoLEP procedures (52649, Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed]). CCI 14.0 promptly bundles this code with a multitude of other urology procedure codes. Column 1 code 52649 is mutually exclusive with many prostatic procedures for benign prostatic hyperplasia (BPH), including column 2 codes 52450 (Transurethral incision of prostate) and TURP codes 52612-52640 (Transurethral resection ...). How it works: Comprehensive/component edits describe bundled procedures. That is, CMS considers the code listed in column 2 as the lesser service, which is included as a component of the more extensive column 1 procedure. More edits: CCI also bundles column 1 code 52649, with column 2 codes 51040, 51102, 52001, and 52005-52240, all with a 1 modifier indicator. Then, CCI bundles column 1 code 52649 with column 2 codes 51700, 51701-51703, 52000, 52276 (internal urethrotomy), 52281 (cystoscopy and urethral dilation), 52400-52500, 52601, 52647-52648, and 53600-53665 -- all with a 0 indicator, which means you cannot bypass the edits, regardless of the circumstances. Additionally: CCI also considers column 1 codes 55866 (Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing) and 55873 (Cryosurgical ablation of the prostate [includes ultrasonic guidance for interstitial cryosurgical probe placement]) mutually exclusive with column 2 code 52649. These edits have [...]