Urology Coding Alert
Lithotripsy With Other Procedures
Illinois Subscriber
Answer: You're on the right track. You should first report 52353 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy [ureteral catheterization is included]) for the ureteroscopy and fragmentation of the renal stones. Append modifier 52 (Reduced services) to indicate a reduced service because the urologist didn't perform the cystourethroscopy.
Next, report 44380 (Ileoscopy, through stoma; diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]) for the looposcopy. You'll need to attach modifier 51 (Multiple procedures) to this code because the urologist performed multiple procedures in one operative session.
In addition: For the loopogram, you should report 50690 (Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service). Append modifier 51 to this code as well.
Last: You should report 74425 (Urography, antegrade [pyelostogram, nephrostogram, loopogram], radiological supervision and interpretation) with modifier 26 (Professional component) appended for the interpretation of the x-rays.
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