Urology Coding Alert

Question: I am wondering how best to code percutaneous nephrolithotripsy when interventional radiology (IR) performs the access to the kidney. IR is coding CPT 50393 and CPT 50392 done the day prior to the Urology surgery. Urology comes in the next day, accesses the kidney thru the established nephrostomy, dilates the tract, performs lithotripsy, and inserts a ureteral catheter. IR and urology are sort of sharing the work of code 50080-81 in separate operating sessions. Urology is also doing most of 50080-81, but is not creating the percutaneous passageway. There is also code 50561, but that does not describe lithotripsy. What is the correct way to report this surgery for my urologist's work? Washington Subscriber Answer: You should bill 50080 (Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extraction; up to 2 cm) or 50081 (... over 2 cm) based on the [...]