Wiki TURBT

[dballard2004]

I'm new to urology coding, and I have a question regarding TURBTs, please...

What is Medicare's guidance regarding these procedures? I have heard that Medicare may deny for a TURBT if the size isn't documented by the urologist. Just stating "Large/Small" is not acceptable. The actual size must be documented and cannot come from the radiology report and can't be measured after removal.

Where can I find the specific guidance from Medicare on this? Thanks.

 

[alp.jeffrey]

Do you mean TURBT? TURP and TURBT are different. As far as sizing, I haven't had issues with any insurance denying if the wording just states "Small, Medium or Large." Would I prefer a size, yes. I can't find a Medicare guideline for it. I just go by what the CPT book states and it has the wording of small, medium and large. Someone else may have a different opinion on this or may even have a guideline from Medicare. Good luck with Urology.