Wiki CPT help on bladder neck contracture

[Miko24]

A DVIU scope 20-French was placed through the urethra up to the bladder neck where the tight area was visualized. A 0.035 guidewire was passed through this without any difficulty. It was probably opened enough that it could have accommodated one 0.035 guidewire. With the guidewire in place, I took the cold knife, cut at the 12 o'clock position. The urethra easily opened up with this. Scar tissue was noted. There was minimal bleeding initally but then the area started to bleed. Foley catheter was placed and I tried to use it tamponade the bleeding. This was unsuccessful. Foley catheter was removed. Cystoscope was placed back in. There was some bleeding at the 12 o'clock position. The wire was removed. I tried to use a Bugbee to cauterize. This was unsuccessful. I then placed a resectoscope with the rollerball. I set the he had settings low. I was able to successfully cauterized 2 areas at the 12 o'clock position which were bleeding fairly briskly. With hemostasis now obtained the resectoscope was removed

I am not sure if 52276 is the appropriate cpt code to use...
N32.0

Thank you.

 

[liqgold2@aol.com]

If this clinical scenario followed a bladder neck contracture, really a urethral stricture at the anastomosis of the urethra and bladder after a radical prostatectomy, then 52276 would be appropriate with a diagnosis of urethral stricture. Otherwise,if the bladder neck contracture followed as a complication of a TURP, bill 52450-52 for the incision of the bladder neck only and not the full prostatic urethra. The latter diagnosis would be N32.0

 

[liqgold2@aol.com]

Also bill 52450-52 for incision(s) of a bladder neck contracture/obstruction secondary to prostatic tissue enlargement specifically at the bladder neck seen in males of younger age than the typical BPH in older men causing lower urinary symptoms.