Wiki 52224 vs 52204

sbosley

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My urologist is having issues with Humana denying 52224. This is what he documents:

Cystourethroscopy:
Indication --hematuria, kidney stone boosx,epididymo-orchitis.
Findings -- small lesion; erythema vs. CIS biopsied, fugurated and lavage done less than 0.5 cm. posterior wall.
Bladder -- Erythema vs. CIS.
Urethra Findings -- Bladder neck to Veru : 3.5.
Trigone --.
Prep Pt was undressed and prepped with 1% Lidocaine HCL gel.
Antibiotic Cipro 500 x2 -- Pt instructed to take 1 now and 1 tonight.
Uroflow PT FLOWED 22 MLS IN 8 SECS WITH PVR OF 22 MLS
VERSED 5MG/10MLS GIVEN TO PT BY MOUTH
*After informed consent was obtained, he was taken to the procedure room and after induction of local anesthetic , he was placed in the standard dorsal lithotomy position, and prepped. Cystourethroscopy was performed with straight and right angle lenses. The entire urothelium was visualized. A small lesion, less than 0.5 cm located on posterior wall biopsied and fulgurated. Urine was sent for culture and sensitivity. Lavage specimen was sent for cytology. The bladder was drained and scope removed. Patient to follow up next week to discuss findings and further treatment options.*.

ANY HELP WOULD BE APPRECIATED! Humana suggests using 52204, but he is documenting that he does the fulguration?
 
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