Wiki PCNL with two Urolgists

[Heinzjulie]

Can someone help to make sure coding for the PCNL is correct? I have 2 Urologists that both work on a PCNL one performs the access and dilation while the second provider then performs the Stone extraction and any other procedure such as retrogrades and/or stent placement etc.. I am looking for the appropriate coding for the initial access and then dilation of the tract? There is pushback due to the description of the 50437 stating it is an existing tract.

cpt 50432 52 modifier
cpt 50437 Xu modifier

Thank you

 

[daniel]

Hi. Focus on the tale end of the description of CPT 50437 including new access into the renal collecting system.
I would code as followed, based the updated AMA (CPT) guidelines saying to use CPT 50436/50437 w/50080/81.
One provider CPT 50437
Second provider 50080-81, 52352/52353/52356 (retrograde selection), 74420.26 if retrograde interp done.

You could say medicare is still bundling CPT 50437 with CPT 50080-81, so you suggest to bill CPT 50080-81 (provider one) and CPT 50080-81.80.82 for the assistant of the dilation by the second provider.

Hope this helps
Regards,

 

[Heinzjulie]

Thank you