Urology Coding Alert

Question: My urologist performed a TURP followed with a suprapubic cystotomy with suture of the inferior vesical artery at the level of the bladder neck. Is the suture of the vesical artery included in 52601 for the TURP?? Texas Subscriber Answer: No. The suture of the vesical artery would not be included in 52601 (Transurethral electrosurgical resection of prostate , including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included]). The suture procedure via a suprapubic cystotomy is to control excessive bleeding following the TURP. So report  the transurethral resection of the prostate (TURP) using 52601, and then bill the 51040 (Cystostomy, cystotomy with drainage) for the suprapubic cystotomy with suture performed on the same day and during the same encounter as the TURP. Append modifier 59 (Distinct procedural service) to the cystostomy code (51040) to indicate your urologist performed a separate procedure [...]