jrmurphy2015
New
Hello all. Can anyone help with this scenario? I am leaning towards 52281 because the provider also used dilators after incising the strictures; but we authorized 53010. Someone else suggested 52276. I'm at a loss being new to Urology coding.
"The patient was brought to the operating suite. A 20-French cystoscope was inserted and revealed a bulbar urethral stricture. I removed the cystoscope and then inserted a rigid urethroscope, 7-French. I was able to navigate through the stricture and there was a secondary stricture about 10 mm from the membranous urethra. I was able to navigate beyond this into the bladder and passed a wire. I then removed the 7-French urethroscope and then alongside the wire I inserted the 20-French internal optical urethrotomy. I then first went to the stricture in the bulbar urethra. This stricture was about 7-French in diameter less than a millimeter in length. I did incise it at 3 o'clock, 7 o'clock, and roughly 6 o'clock in a Mercedes Benz-type incision. I then went to the second stricture and did incise that in the same way with the urethrotomy knife. This stricture was about 10 mm beyond the verumontanum. There was also a stricture about 10-French in the membranous urethra. I did not want to incise this. I had a wire already through this. I used Heyman dilators and gently dilated from 10-French to 20-French. I removed the Heyman dilators and then inserted the 20-French cystoscope. The two urethral strictures were dilated nicely. The membranous urethra was dilated. Upon entering into the bladder, it was moderately trabeculated. Right and left urethral orifices were seen with clear urine from both. Nothing suspicious of carcinoma in situ or transitional cell carcinoma. The safety wire remained in the bladder. Cystoscope removed and then I easily passed an 18-French Councill tip Foley into the bladder."
Thank you all,
Jen
"The patient was brought to the operating suite. A 20-French cystoscope was inserted and revealed a bulbar urethral stricture. I removed the cystoscope and then inserted a rigid urethroscope, 7-French. I was able to navigate through the stricture and there was a secondary stricture about 10 mm from the membranous urethra. I was able to navigate beyond this into the bladder and passed a wire. I then removed the 7-French urethroscope and then alongside the wire I inserted the 20-French internal optical urethrotomy. I then first went to the stricture in the bulbar urethra. This stricture was about 7-French in diameter less than a millimeter in length. I did incise it at 3 o'clock, 7 o'clock, and roughly 6 o'clock in a Mercedes Benz-type incision. I then went to the second stricture and did incise that in the same way with the urethrotomy knife. This stricture was about 10 mm beyond the verumontanum. There was also a stricture about 10-French in the membranous urethra. I did not want to incise this. I had a wire already through this. I used Heyman dilators and gently dilated from 10-French to 20-French. I removed the Heyman dilators and then inserted the 20-French cystoscope. The two urethral strictures were dilated nicely. The membranous urethra was dilated. Upon entering into the bladder, it was moderately trabeculated. Right and left urethral orifices were seen with clear urine from both. Nothing suspicious of carcinoma in situ or transitional cell carcinoma. The safety wire remained in the bladder. Cystoscope removed and then I easily passed an 18-French Councill tip Foley into the bladder."
Thank you all,
Jen