Urology Coding Alert

Question: How can we get paid for placing a stent (52332) during the postoperative period of a stone removal?

Utah Subscriber

Answer: If you place a stent after ureteroscopic stone extraction (52352, cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus [ureteral catheterization is included]) use 52332 (cystourethroscopy, with insertion of indwelling ureteral stent [e.g., Gibbons or double-J type]) without a modifier because 52352 has a 0-day global period. If you place a stent during the postoperative period of a 90-day procedure, such as 50590 (lithotripsy, extracorporeal shock wave), add modifier -58 (staged or related procedure or service by the same physician during the postoperative period) or -78 (return to the operating room for a related procedure during the postoperative period) to 52332. Use modifier -58 for a prospectively planned stent, in this case. (Modifier -58 is also for a procedure that is more extensive than the original, or for therapy following a diagnostic surgical procedure.) If the stent is needed for treatment of a complication, use modifier -78. Using modifier -58 results in full payment for the procedure, while use of modifier -78 results in about 60 percent of the global fee because only the intraoperative portion of the procedure is paid.