Urology Coding Alert

Question: A patient had carcinoma in situ (CIS) involving over half of his bladder. Our physician fulgurated the whole area but did not do a resection. Should I code this as 52240 or as 52224-22?


West Virginia Subscriber


Answer: You should use 52240 (Cystourethroscopy, with fulguration [including cryosurgery or laser surgery] and/or resection of; large bladder tumor[s]) to report this procedure. Because the code descriptor for the transurethral resection (TUR) of bladder tumors procedure specifies fulguration and/or resection, this is the appropriate code. 

For a TUR of a bladder tumor, you report 52234 (Cystourethroscopy, with fulguration [including cryosurgery or laser surgery] and/or resection of; small bladder tumor[s] [0.5 up to 2.0 cm]), 52235 (Cystourethroscopy, with fulguration [including cryosurgery or laser surgery] and/or resection of; medium bladder tumor[s] [2.0 to 5.0 cm]), or 52240 based on the size of the tumor. In this case, since the urologist fulgurated over half the patient's bladder, 52240 is the best choice.

Report ICD-9 code 233.7 (Carcinoma in situ of breast and genitourinary system; bladder) as well.

Caution: Any biopsies of the tumor that your urologist may perform are included in the treatment and fulguration, so you cannot separately report them.