Urology Coding Alert

Question: Does CPT code 52337 include electrohydraulic/(any technique) lithotripsy?

Louisiana Subscriber

Answer: In 52337 (cystourethroscopy, with ureteroscopy and/or pyeloscopy [includes dilation of the ureter and/or pyeloureteral junction by any method]; with lithotripsy [ureteral catheterizaiton is included]), the stone(s) are crushed under direct vision using a lithotriptoscope. For 50590 (lithotripsy, extracorporeal shock wave), the urologist pulverizes the stone(s) using shock waves sent transcutaneously. However, CCI states that 52337 is a component of 50590. Separate payment is possible under specific circumstances (e.g., different session/encounter, different site/organ, etc.) as unbundling is allowed. Other third-party payers may or may not bundle the procedures depending on their policy. Review the payers coding guidelines or contact the payer for additional information.