Wiki Procedure question

greendm

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Can anyone help me find the codes for this procedure? I appreciate any input I can get. I have not seen this before.

A standard 21 Fr rigid cystoscope was advanced into the urethra. No strictures or abnormalities were found in its distal portion. In the prostatic urethra a large aggregate of stones is noted embedded in the posterior wall of the urethra, presumably surrounding a radiation seed.
Once in the bladder no tumors or stones were observed. The bladder walls show signs of radiation cystitis. The cystoscopic bladder capacity is significantly reduced (150cc) Both the ureteral orifices were identified and found in a normal position.
At this point a rigid grasper was introduced into the cystoscope and was used to "scoop out" the stone. This was difficult and required the combined use of a resectoscope to resect the surrounding prostatic tissue and the scar tissue. One seed was removed along with the stone and pushed into the bladder. The stone, the scar tissue and one metal seed were drained out of the bladder using a Ellik evacuator. At this point the procedure terminated.

Dictation shows this as Procedure:
MECHANICAL FRAGMENTATION AND REMOVAL OF THE STONE and surrounding prostatic tissue
BIPOLAR TURP

Thank you!
 
Tough case, CPT 52325 doesn't seem to fit. I don't see this as a TURP 52601.

I'm looking at 52318 + 52224 (scar tissue dx), I think this may be the best fit.

Hope this helps
 
Thank you! I will take a look at these codes. Was looking at 52630(since he did resect prostatic tissue-pt had previous TURP) & 52315, but those 2 can't be billed together.
 
With this additional information, I'd code CPT 52630 only. It's actually more favorable then 52318 + 52224.
If this case came across my workload, I would of went back in the chart to see if there was a prior TURP. I should of asked.

I'd stick with 52630.
 
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