Wiki 52353-52352

[charonate]

Does anybody know when to bill both codes with mod-59.

eg.
If a patient has a stone on the left side manipulation and litho was performed can I bill for both codes?

Thank you,
Charo

 

[Kelly_Mayumi]

Billing with -59

You may bill 52352 and 52353 when one of these procedures is preformed on the contralateral side. EX. if you have a ureter stone on the left side and it is basket extracted, then use 52352. If you have a renal stone on the right and a laser is used to break it up, use 52353. -59 will go on 52352 because it is the "lesser" procedure and use LT and RT on the proper cystoscopic code to show the insurance that these services were not performed on the same side.

 

[BMICHAUN]

You may bill 52352 and 52353 when one of these procedures is preformed on the contralateral side. EX. if you have a ureter stone on the left side and it is basket extracted, then use 52352. If you have a renal stone on the right and a laser is used to break it up, use 52353. -59 will go on 52352 because it is the "lesser" procedure and use LT and RT on the proper cystoscopic code to show the insurance that these services were not performed on the same side.

I have another question about both codes 52353-52352 can the be billed x2 if done in ureter and kidney both on the left side with modifier 59 appended to the the second procedure example 52353LT 5235359LT 5235259LT 523525951 PLEASE HELP!!!

 

[Kelly_Mayumi]

No, you should not attach -59 to a procedure taking place on the same side. 52352 and 52353 are bundled and 52352 is a component of 52353 and 52353 is a more extensive procedure. If you are treating stones in the kidney and the ureter, you probably have to clear the ureter stones before you get to the kidney.