Urology Coding Alert

Question: The urologist did a cystourethroscopy and insertion of cystostomy tube. Two days later, the patient pulled out the tube, and the same procedure had to be repeated. I plan on using 52332 for both procedures but with a -78 modifier for the second time it was done. Is this correct or is there a better way to code this?

New York Subscriber

Answer: You should report code 52332 (cystourethroscopy, with insertion of indwelling ureteral stent [e.g., Gibbons or double-J type]) when a stent is placed in the ureter. To report change of a bladder tube via cystourethroscopy, codes 52000 (cystourethroscopy [separate procedure]) and 51705 (change of cystostomy tube; simple) or 51710 (change of cystostomy tube; complicated) are more appropriate. Since these procedures are 0-day global procedures, modifier -78 (return to the operating room for a related procedure during the postoperative period) is unnecessary.