Urology Coding Alert

Question: How do I code a bilateral ureteral stent change done through a cystourethroscopic approach? I have only been using 52332 (cystourethroscopy, with insertion of indwelling ureteral stent) with a modifier -50 (bilateral procedure). There has been some question as to the appropriateness of billing 52310 (cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder [separate procedure]; simple) additionally to reflect the work involved in removing the old stents before placing the new stents. Should I report 52310 with a modifier -59 (distinct procedural service) in addition to 52332-50?

Anonymous Texas Subscriber

Answer: No, in this case bill 52332-50 only. Code 52310 is a separate procedure and as such would only be billed if done as the only procedure performed during an operative session. If done with other, more comprehensive services, 52310 is considered integral to the larger procedure and should not be billed.