Urology Coding Alert

Question: In the last Urology Coding Alert , there is an article about the new CPT 52649 for HoLEP procedures. Is this the code we are to use for the Revolix procedure?

Kansas Subscriber

Answer: The Revolix procedure for laser prostatectomy is very similar to the Holmium laser treatment of the prostatic adenoma. Code 52649 (Laser enucleation of the prostate with morcellation ...) is for the particular technique wherein the urologist enucleates the prostatic adenoma as a whole lobe (not pieces) with the laser, and then washes the enucleated adenoma into the bladder where subsequently the urologist morcellates the adenoma to allow its removal by bladder irrigation -- this is the HoLEP procedure.

If your urologist performs this particular technique, the prostatic adenoma must be morcellated before he can irrigate it from the bladder, and you should report 52649.

Alternative: If the urologist specifically vaporized just the prostate alone with the laser or Revolix, you should instead use 52648 (Laser vaporization of prostate, 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]).

Bottom line: The Revolix is a laser treatment. Codes 52649 and 52648 are the procedure codes you'll choose most often for any laser treatments. The new CPT code, 52649, is for a particular technique and does not specifically reference a particular laser beam and its specific wavelength.