Wiki 2 Stones on 1 side

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KaylaRieken

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How many of you are coding separate for renal and ureteral stones using the XS modifier? If patient has a left ureteroscopy,left laser lithotripsy of a renal stone, left basket extraction of a ureteral stone, and left stent placement.

Are you coding this as 52356 LT N20.0, and 52352 XS LT N20.1? Or are you coding this just as 52356 LT?
 
I would NOT recommend this with Medicare. It is a high issue with RAC for takebacks. Basically the thought process is, if you are using litho & the fragments won't pass on their own? You HAVE to basket them anyway. I do bill it this way to commercial insurers, though.
 
What about if you basket out a ureteral stone first and then laser a renal stone on the same side. For Medicare you would just bill the 52353 and not 52353 and 52352xs?
 
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