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Urology Coding Alert

Reader Questions:

Know Your Pyelogram Bundling Edits

Published on Sat Jan 16, 2010

Question: A physician does a pyelogram on both the left and right side ureter. Can I code both? I'm reporting the pyelogram along with code 52332-50 for a bilateral stent insertion. I see that modifiers 50/LT/RT are not allowed with 74420-26. Does that mean I can bill it only once per session? Also, if the urologist does a retrograde pyelogram to "verify" what was done during a procedure, can I bill for it or is it considered part of the primary procedure? Washington Subscriber Answer: The Correct Coding Initiative (CCI) bundles a retrograde pyelogram (52005, Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiological service) into 52332 (Cystourethroscopy, with insertion of indwelling ureteral stent [e.g., Gibbons or double-J type]), and you cannot unbundle this edit. For your clinical scenario you should report the following codes: • 52332 for the stent insertion; • Append modifier 50 (Bilateral [...]
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