Urology Coding Alert

The value of CPT code 52332 (cystourethroscopy, with insertion of indwelling ureteral stent [e.g.., Gibbons or double-J type]) is increasing, making it more cost effective for urologists to perform the procedure in the office. Code 52332 is rising in value from $688 in non-adjusted Medicare payments for 2000 to $1,138 for 2002. Due to the switch from charge-based to resource-based practice expense values, the value of many CPT codes is growing. New practice expense values are being phased in over three years, so with implementation beginning in 1999, the values will not be fully implemented until 2002.

The justification for the increase for 52332 is to pay for the supplies involved with the procedure in particular, the catheter, explains Ray Painter, MD, a urologist who is president of PRS, a Denver-based coding, reimbursement, and compliance consulting firm. Since Medicare would not pay for the catheter separately, few if any urologists would perform this procedure in the office. Instead, it was done in the hospital. It is possible that now, with the increased reimbursement, you may be able to afford to do this in the office.

See the insert in this issue for a list of the top urology codes with the highest Medicare allowed charges and their 2000 payments compared to 2002.