Wiki Discontinued Ureteroscopy

[molly3]

I am new to Urology and I have a tough case I'm hoping someone can help with. Patient has a confirmed ureteral stone. Dr. uses rigid then flexible scope in attempts of reaching the stone and grabbing with a basket. Both were unsuccessful and stone was pushed up into kidney. Also, a laser fiber was used which was unsuccessful as well. At that point he discontinued the procedure and placed a J stent.

I'm thinking: 52332/53 ureteroscopy
52005 pyelogram
74420/26 ??
52332 stent placement

Thanks so much,
Molly

 

[emcee101]

Just because the attempt to litho and basket the stone did not work is irrelevant to your coding - The procedure was not discontinued, it was simply unsuccessful, which can happen from time to time. You should not modify your code and reduce the payment that your doctor deserves for their efforts. From a coding perspective, since a lithotripsy and double-J stent were inserted you should use code 52356, which encompases both procedures that used to be reported separately using 52353 and 52332. If a pyelogram was also performed then you can add 74420-26 as well, but 52005 is always going to be bundled into other ureterscopy procedures and should not be billed separately.