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Urology Coding Alert

Reader Questions:

52214 vs. 52234 Depends on Resection

Published on Mon Jan 17, 2011

Question: During laparoscopic nephroureterectomy for renal pelvic tumor we start the case by cystoscopically placing a guidewire and using a resectoscope to excise the ureteral orifice with surrounding bladder cuff. What code would you suggest for the cystoscopic portion of the case?Answer: The optimum curative surgery for a renal pelvic tumor includes total removal of the kidney and ureter including the ureteral orifice and a cuff of bladder surrounding the orifice. For the cystoscopic excision of the ureteral orifice and bladder cuff, use 52214 (Cystourethroscopy, with fulguration [including cryosurgery or laser surgery] of trigone, bladder neck, prostatic fossa, urethra or periurethral glands).On the other hand, if a transurethral resection of the orifice and surrounding bladder is performed as a preliminary procedure before the laparoscopic total nephroureterectomy, code 52234 (Cystourethroscopy, with fulguration [including cryosurgery or laser surgery] and/or resection of; small bladder tumor[s] [0.5 to 2.0 cm]). Even though a bladder [...]
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