The only thing that we can find to stand our ground on is the fact that CCI Edits do not bundle it and the CPT Guidelines do not say, "do not bill 52352 in conjunction with 52356" as it does with the other two codes. We are going to bill the 52352 along with the 52356 also.
Can You Bill a 52353 and 52352 on the same side?
Per their recommendation, you can bill a 52353 and a 52352 on the same side, if done in separate structures to separate stones. For example, the provider does lithotripsy and basket removal of pieces of the stone in the kidney, and then also removes a separate stone in the ureter.
What is the difference between CPT code 52320 and 52356-lt?
Whereas in CPT code 52320 there is almost same procedure with exception of uretoscopy, which is also done in your case. So, it is appropriate to bill 52356-LT and 52352-59,LT.
What is CPT code 52356 for ureteroscopy?
Code 52356 (cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent [eg, Gibbons or double-J type]) includes the performance of lithotripsy and the insertion of the indwelling stent on the same side.
Can 50590 be billed more than once per side?
All of my coding materials show that 50590 can only be billed one time per side, whether the urologist treated more than one stone in the kidney or kidney and ureter. Can you clarify this? As explained above, for Medicare patients, you cannot charge for more than one stone on the same side at the same setting, regardless of how it is treated.
Can you code 52332 and 52352 together?
Note: CPT® code 52332 can be billed in addition to other procedure unless the placement of the stent is bundled to another procedure. For example, CPT® code 52332 can be billed in addition to CPT® codes 52320-23440, 52334-52352, 52354, 52355 (consider appending modifier 51 if needed).Jun 5, 2018
Can CPT 52352 and 52353 be billed together?
52352 Current is bundled into 52353 and can be unbundled with a modifier. Since the two procedures were performed on the same stone it would not be appropriate to append a 59 or any of the X modifiers.Aug 20, 2018
Does CPT code 52356 include the retrograde pyelogram?
A. According to Medicare Correct Coding Initiative (CCI) edits, retrograde pyelograms are bundled into cystoscopy codes 52320 through 52355 and cannot be unbundled, unless the procedure is performed on separate ureters.
Can 52332 and 52356 be billed together?
Do not report 52356 in conjunction with 52332, 52353 when performed together on the same side.
Can CPT code 52332 and 52351 be billed together?
Insertion of an indwelling stent (52332) should always be charged in addition to a ureteroscopy (52351-52354) by adding the 59 modifier.Feb 1, 2004
What is procedure code 52352?
52352. Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of. calculus (ureteral catheterization is included)
What is the difference between 51102 and 51040?
51102. When your urologist states that he placed a suprapubic (SP) tube, you can decide between CPT 51040 (Cystostomy, cystotomy with drainage) and CPT 51102 (Aspiration of bladder; with insertion of suprapubic catheter) if you follow three simple guidelines.Feb 16, 2010
Can 52204 and 52005 be billed together?
Example: If the urologist performs a cystoscopy and retrograde pyelogram as a diagnostic study along with the TURB or biopsy codes, you may bill for both.Nov 16, 2007
Can CPT code 52332 and 52005 be billed together?
CPT codes 52332 and 52005 are not separately reportable for the same ureter for the same patient encounter.
Can CPT 52332 be billed bilaterally?
It is appropriate to bill the CPT® code 52332 with modifier -50 Bilateral Procedure, to indicate the procedure was done bilaterally.
How do you bill for lithotripsy?
Generally, providers bill for lithotripsy procedures using revenue code “0790” (extracorporeal shock wave therapy) and HCPCS code “50590” (lithotripsy).Apr 19, 2010
Can you have a stent put in your kidney?
To perform nephrostomy, a radiologist inserts a stent (tube) directly into a kidney. The kidney stent drains urine from the kidney into a bag outside of the body, bypassing the ureters and bladder. Ureteral stenting is an effective way to allow painful kidney stones to pass through the ureters and out of the body.Aug 25, 2021
What antibiotics did Dr. Xavier receive?
He received IV antibiotics prior to starting the procedure. He was brought to the operating room, placed in the supine position. He had Venodynes for DVT prophylaxis. Anesthesia was induced. He was then placed in lithotomy and prepped and draped in a general sterile fashion.
Is 52356 a recognized code?
Well, I just received a denial for 52356, stating it is not a recognized code. I'm not sure if the insurance companies are all on board with this new code yet.
What is the CPT code for genitourinary tract biopsy?
The CPT Manual contains integumentary system (CPT codes 10000-19999) and genitourinary system (CPT codes 50000-59899) codes to describe various procedures such as biopsy, excision, or destruction. A single code from one of these two sections of the CPT Manual that best describes the biopsy, excision, destruction, or other procedure performed on one or multiple similar lesions at a mucocutaneous border should be reported. Separate codes from the integumentary system and genitourinary system sections of the CPT Manual may only be reported if separate procedures are performed on completely separate lesions on the skin and genitourinary tract. Modifier 59 should be utilized to indicate that the procedures are on separate lesions. The medical record should accurately describe the precise locations of the lesions.”
Can you charge for multiple stones on the same side of the urinary tract?
The current answer is that, for Medicare, you cannot charge separately for the treatment of multiple stones on the same side of the urinary tract. “Same side” includes stones in the kidney, renal pelvis, or ureter regardless of mode of treatment. If the patient’s insurance is Medicare, Medicaid, or another federally funded program ...
Is 59 a modifier?
Given current bundling and payment rules, –59 would likely be the appropriate modifier. Either approach may require appeal and should be checked against any agreed-upon contract policy for the payer. Remember, Medicare has already offered an interpretation blocking reporting of multiple treatments on the same side.
Is a stent coding correct for Medicare?
However, for Medicare, the answer has changed . (Note that the answers to the second and third questions relate to this topic as well.)
Can Medicare charge for modifier 59?
Our answer is always simple: “You don’t even have to change the questions, because the answers keep changing.”. Unfortunately, the answer to questions about modifier –59 and multiple stones has changed multiple times during the past few years. The current answer is that, for Medicare, you cannot charge separately for the treatment ...