Wiki 52354 and 52204?

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lemonsqueezy

lemonsqueezy

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FORT SILL, OK
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Hi! Opinions, please.

OP NOTE INFO:
Cystoscope was introduced. Bladder was examined and papillary lesions were found above and posterior to the left ureteral orifice. These areas were biopsied with cold cup forceps and then fulgurated. Retrograde was then performed, which demonstrated a complete obstruction within the ureter. Ureteroscope was then advanced, but was unable to go beyond the lower ureter. Within the lower ureter, a papillary tumor filled the ureter. Biopsies were obtained throughout the tumor. Ureteroscope was removed. Cystoscope was reintroduced, bladder was drained and scope was removed.

PATH INFO:
A. BLADDER TUMOR BIOPSY:
Papillary urothelial carcinoma, high grade.
B. URETER BIOPSY:
Papillary urothelial carcinoma, high grace.


52354 and 52204 bundle.
Would you unbundle for this case?

Thank you!
 
0
Yes. You could justify unbundling these two CPT codes since they are different anatomical sites. I would bill 52354, 52204-XS. The ureter and bladder are separate organs. Therefore it is appropriate to use modifier "XS" which is defined as "Separate Structure, a service that is distinct because it was performed on a separate organ/structure".

Proper use of Modifiers 59 & X{EPSU}
 
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