Wiki 52310 and 52352 billed together

[Kjt0305]

I am new to Urology, and need to know if a 52310 and 52352 can be billed together?
Thank You!!

 

[CodingKing]

According to NCCI they cannot be billed separately. CPT 52310 has a "separate procedure" indication in the code description meaning its typically included in other CPT codes and not separately reportable. In this case 52352 code description "with removal or manipulation of calculus (ureteral catheterization is included)" Also any other items blocking the insertion of the scope is in integral component to any scope procedure thus not separately reimbursable. No CCI modifiers will bypass this edit.

Excerpt from the NCCI Manual:

22. The code descriptors for CPT codes 52310 and 52315 (cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure)...) include the “separate procedure” designation. Per CMS payment policy for procedures with the “separate procedure” designation, these codes should not be reported with other cystourethroscopy CPT codes for the same patient encounter.