daknaack
Networker
I am wondering if more than 1 code can be billed for the following surgery? (52214, 52234?)
PREOPERATIVE DIAGNOSIS: History of bladder cancer.
POSTOPERATIVE DIAGNOSIS: History of bladder cancer.
PROCEDURE: Transurethral resection of bladder tumor: Three lesions, two 8 mm
lesions and one 1 cm lesion.
DESCRIPTION OF PROCEDURE: He provided informed consent, was placed under
anesthesia and received preoperative antibiotics within an hour of procedure.
He was prepped and draped in lithotomy. A 24-French sheath using the visual
obturator was used and passed easily through the urethra up into the bladder.
Examination was performed on the anterior wall with some mucosal irregularity as
well as the mucosa at the bladder neck in the midline. Posterior wall also had
some erythema. The first two areas were not particularly erythematous, but the
mucosa was somewhat irregular. These were not papillary tumors. The posterior
erythema was also not papillary and the mucosa was fairly smooth. Of note, I
done flexible cystoscopy at the very beginning of the case to examine the
bladder neck on retroflexion, which was mostly unremarkable. I then used the
Iglesias resectoscope and the bipolar loop to resect tissue at the anterior
lower bladder wall about the 12 o'clock position, at the bladder neck in the
midline including the middle trigone and in the posterior wall. The posterior
wall was the largest of the 3 lesions. The tissue was irrigated out separately
and sent separately. I used the coag settings to cauterize the base of the
resection sites and approximately 5 mm of surrounding mucosa with excellent
hemostasis. His bladder was irrigated multiple times. Examination under low
pressure showed no oozing. Scope was removed and he was awakened and taken to
recovery in good condition.
PREOPERATIVE DIAGNOSIS: History of bladder cancer.
POSTOPERATIVE DIAGNOSIS: History of bladder cancer.
PROCEDURE: Transurethral resection of bladder tumor: Three lesions, two 8 mm
lesions and one 1 cm lesion.
DESCRIPTION OF PROCEDURE: He provided informed consent, was placed under
anesthesia and received preoperative antibiotics within an hour of procedure.
He was prepped and draped in lithotomy. A 24-French sheath using the visual
obturator was used and passed easily through the urethra up into the bladder.
Examination was performed on the anterior wall with some mucosal irregularity as
well as the mucosa at the bladder neck in the midline. Posterior wall also had
some erythema. The first two areas were not particularly erythematous, but the
mucosa was somewhat irregular. These were not papillary tumors. The posterior
erythema was also not papillary and the mucosa was fairly smooth. Of note, I
done flexible cystoscopy at the very beginning of the case to examine the
bladder neck on retroflexion, which was mostly unremarkable. I then used the
Iglesias resectoscope and the bipolar loop to resect tissue at the anterior
lower bladder wall about the 12 o'clock position, at the bladder neck in the
midline including the middle trigone and in the posterior wall. The posterior
wall was the largest of the 3 lesions. The tissue was irrigated out separately
and sent separately. I used the coag settings to cauterize the base of the
resection sites and approximately 5 mm of surrounding mucosa with excellent
hemostasis. His bladder was irrigated multiple times. Examination under low
pressure showed no oozing. Scope was removed and he was awakened and taken to
recovery in good condition.