Urology Coding Alert

The ‘once-in-a-lifetime’ rule on TURPs limits the codes you can report Determining which code to report for transurethral resection of the prostate (TURP) procedures can be a daunting task. Read on to find the answers to some frequently asked questions about reporting TURP procedures.

You have only five CPT Codes to choose from to report TURP procedures, but selecting the right one can be tricky. The most commonly used TURP codes are 52601 (Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included]), CPT Code 52620 (Transurethral resection; of residual obstructive tissue after 90 days postoperative), and 52630 (... of regrowth of obstructive tissue longer than one year postoperative). You Can Report 52601 Only Once The first code you should consider for reporting a TURP procedure is 52601. During a TURP, the urologist inserts a resectoscope through the urethra and removes a portion of the prostate. The TURP procedure, and the definition of 52601, includes several other urological services, including meatotomy and urethral dilation. Because these procedures are intrinsically part of the TURP procedure, you can’t report them separately and, therefore, you should only report 52601.

Note: Code 52601 represents a “once-in-a-lifetime” procedure and you can report it only for the first TURP done on a patient, says Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 31-urologist practice in Indianapolis.

Coding example: A patient with frequent urination, overflow incontinence and hematuria presents to your practice. Your urologist concludes that the patient has benign prostatic hyperplasia (BPH), commonly referred to as enlarged prostate. Because the patient’s symptoms are severe, your urologist decides to perform a TURP. You should report 52601 along with diagnosis code 600.01 (BPH with urinary obstruction). Use 52620 for Repeat TURPs Within 1 Year When your urologist performs a TURP on a patient who has had a previous TURP, you’ll need to report either 52620 or 52630 in place of 52601. “Code 52620 is for patients who have had a previous TURP, over 90 days ago but less than one year ago, by any provider,” Hause says.

Coding example: Your urologist sees a patient who has a prostatic fossa with regrown prostatic tissue from prostate cancer. The doctor performs a cystoscopy and evacuation of multiple obstructing clots, followed by a TURP. The patient had a prior TURP procedure just eight months before. You should report 52001-59 (Cystourethroscopy with irrigation and evacuation of multiple obstructing clots) for the cystoscopy and for the evacuation of clots. For the TURP procedure, which falls within one year of [...]