Urology Coding Alert

Check your complicated case savvy against the advice from the experts. Find out if you're set to properly code your urologist's bladder tumor removal procedures by checking your answers to the five quiz questions on page 75 against this answer key. Answer 1: Avoid Adding Up Tumor Sizes For Medicare For Medicare, you'll report CPT 52235 (Cystourethroscopy, with fulguration [including cryosurgery or laser surgery] and/or resection of; medium bladder tumor[s], 2.0 to 5.0 cm) for this case since the largest tumor fits the medium-tumor code description. You should not add up the sizes of every tumor the physician removes when billing Medicare. Instead, choose the code that represents the size of the largest single tumor resected, says Becky Boone, CPC, CUC, certified reimbursement assistant for the University of Missouri Department of Surgery in Columbia. Some private carriers, though not all, will allow you to add up the tumors. Therefore, for [...]