Urology Coding Alert

Delaware Subscriber

Answer: The diagnosis for a procedure is always the reason or medical necessity for doing a procedure, no matter what surgical approach your urologist uses.

How it works: If the physician does a robotic radical prostatectomy or an open retropubic radical prostatectomy, the diagnosis would always be prostatic carcinoma (185) for either procedure.

Keep in mind: When your urologist performs a robotic (assisted) procedure for a non-Medicare carrier, you can add CPT code S2900 (Surgical techniques requiring use of robotic surgical system [List separately in addition to code for primary procedure]) to your procedure billing for the physician's use of the robotic technology.

Example: Your urologist performs a laparoscopic pyeloplasty using the da Vinci surgical robotic system. For Medicare, you should report 50544 (Laparoscopy,surgical; pyeloplasty) alone. For private payers that accept S2900, you should report 50544 and S2900.

Note: S2900 is an add-on code and, therefore, will not require modifier 51 (Multiple procedures) or a fee reduction.