Wiki Need help with transureteral resection

[Coder 646]

I'm absolutely stumped on what CPT code to use for cystoscopy with transurethral resection of ureter orifice ONLY.
Not a TURBT.

Procedures:
Right antegrade flexible ureteroscopy, cystoscopy with transurethral resection of right ureteral orifice, conversion to right ureteral stent, nephrostogram

Able to find intramural ureter using resection down onto antegrade ureteroscope. 　No evidence of tumor in the ureter or renal collecting system. 　Retrograde placement of 8-French by 24 cm double-J ureteral stent. 　16-French 2-way Foley.

any suggestions would be so helpful

 

[fwnewbie]

I would start with the nephrostogram.

 

[liqgold2@aol.com]

This sounds to me as a severe meatal stricture that needs an incision opening. I would consider CPT code 52290 for the resection of the ureteral orifice stricture opening. My diagnosis would be N13.0
Michael A. Ferragamo MD, FACS

 

[Coder 646]

This sounds to me as a severe meatal stricture that needs an incision opening. I would consider CPT code 52290 for the resection of the ureteral orifice stricture opening. My diagnosis would be N13.0
Michael A. Ferragamo MD, FACS

Thank you. I have another question. If a urologist states a radical orchiectomy, 54530, it's done inguinally, BUT she doesn't biopsy explore lymph nodes, and the mass is a hemoatoma.
Would this be enough for the 54530 or do we need to use 54520-22?

 

[Coder 646]

Thank you. I have another question. If a urologist states a radical orchiectomy, 54530, it's done inguinally, BUT she doesn't biopsy explore lymph nodes, and the mass is a hematoma.
Would this be enough for the 54530 or do we need to use 54520-22

 

[liqgold2@aol.com]

If the preoperative diagnosis was a testicular tumor, suspicious for carcinoma, then a radical orchiectomy, 50530, would be the correct coding.