Wiki Pre-op Ureteral Stent placement dx?

[Jessim929]

I'm probably overthinking this, but my docs frequently get asked to place stents for ureteral identification when patients are having other surgery - GI and GYN are most common. When I bill them, there's usually not a GU diagnosis, so I've been using the preop code (Z01.818) and the diagnosis for whatever surgery they're having (i.e. "GI cancer") and as far as I know it's getting paid, and the documentation backs what I'm using, but I can't help but wonder if there's a more appropriate coding.

Anyone have any thoughts?

Thank you!!

 

[thomas7331]

I'd agree with you on assigning the diagnosis that is the reason for the surgery, but I would not assign Z01.818 because the placement of a stent is not an 'examination'. If the procedure is required as a part of the plan of treatment for the patient's condition, then it is a therapeutic procedure the purpose of which is the treatment of the condition rather than a preprocedural formality, and so I believe it is accurately reported using that diagnosis. As a similar example, if a surgeon places a port for chemotherapy, even though the surgeon isn't directly treating the cancer with this procedure, it's still coded with the cancer diagnosis because it's a required part of the comprehensive cancer treatment.

 

[liqgold2@aol.com]

Remember for ureteral stents preop bill 52005 for bilateral ureteral catheters not stents for Medicare and 52005-50 for non Medicare insurance. For diagnoses if you find pathology, bill for that pathology such as with N13.39, N13.4.
If the study is normal, bill for the diagnosis of the surgeon.
If the carrier will not pay for the above diagnoses of the surgeon because these are not urological diagnoses, then bill Z40.8, N13.39 and Z46.6. I hope this helps and is not more confusing.

 

[Jessim929]

Remember for ureteral stents preop bill 52005 for bilateral ureteral catheters not stents for Medicare and 52005-50 for non Medicare insurance. For diagnoses if you find pathology, bill for that pathology such as with N13.39, N13.4.
If the study is normal, bill for the diagnosis of the surgeon.
If the carrier will not pay for the above diagnoses of the surgeon because these are not urological diagnoses, then bill Z40.8, N13.39 and Z46.6. I hope this helps and is not more confusing.

Bill catheters even if they specifically say stents and talk of strings left?