Urology Coding Alert

Question: During an operative session my urologist performed brachytherapy in conjunction with a radiation oncologist. My doctor also performed cystoscopic removal of a radioactive seed that had been displaced into the bladder. His documentation doesn't say much about this part of the procedure, other than a general comment. Is this something that is normally done during brachytherapy or something I should separately code?

Pennsylvania Subscriber

Answer: The correct answer depends on the payer involved. If the patient has Medicare coverage, you should consider the cystoscopy and the removal of a displaced seed or seeds at the time of the brachytherapy as part of the operative procedure and not a separately billable service.

Exception: For private payers, you may receive additional and separate reimbursement for the foreign body removal at the time of the brachytherapy. For single seed removal, report 52310 (Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder [separate procedure]; simple), and for the removal of more than one seed, report code 52315 (Cystourethroscopy, withremoval of foreign body, calculus, or ureteral stent from urethra or bladder [separate procedure]; complicated).