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Urology Coding Alert

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Code Lymph Node-Less Radical Nephrectomy

Published on Sat Oct 11, 2003

Question: My urologist performed a laparoscopic radical nephrectomy but did not remove the regional lymph nodes. How should I report his services?

Maine Subscriber

Answer: You'll have to use modifier -52 (Reduced services) to indicate that the urologist did not perform all of the components.
 
The code for a laparoscopic radical nephrectomy (50545, Laparoscopy, surgical; radical nephrectomy [includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy]) includes the removal of regional lymph nodes, overlying fascia and Gerota's fascia as well as removal of the adrenal gland.
 
When you append modifier -52, the carrier will reduce the fee for your urologist's service depending on what the urologist documents performing. Be sure when you submit the paper claim you include a statement from the urologist stating, "I performed everything indicated by CPT 50545 except removal of the regional lymph nodes."
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