Urology Coding Alert
You Be the Coder:
Bladder Biopsy to Rule Out Cancer
Published on Wed Oct 25, 2017
Question: The urologist performed a bladder biopsy to rule out a cancer diagnosis. She used cold cup biopsy forceps to obtain tissue without cautery for pathology; this was sent off for permanent section as posterior wall. Additional cold cup biopsies were taken of the left and right trigone, and sent off separately for permanent pathology. I am using code 52204 for the biopsy but am unsure whether I should also include 52214. What do you recommend? Arizona Subscriber Answer: Based on the information you shared, the urologist only performed biopsies, not fulguration or destruction. Because of this, code 52204 (Cystourethroscopy, with biopsy[s]) is appropriate for this clinical scenario.
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