Urology Coding Alert

Question: How should I report a varicocele embolization the urologist performs at the hospital in interventional radiology?

Oklahoma Subscriber  Answer: You should report three codes for your urologist's services in this case.

Step 1: Report 37204 (Transcatheter occlusion or embolization [e.g., for tumor destruction, to achieve hemostasis, to occlude a vascular malformation] ...) for the embolization of the varicocele.

Step 2: For the radiological supervision and interpretation, assign 75894 (Transcatheter therapy, em-bolization, any method, radiological supervision and interpretation). To indicate that the urologist is providing only the radiological supervision and interpretation, append modifier 26 (Professional component) to 75894. Although the urologist is also performing the study, you should not bill for the technical component of the study because the physician does not own the radiological equipment and does not pay for the assisting technician or for any supplies used. The hospital/radiological department will most likely bill these charges on their cost report.

Step 3: Use 75825 (Venography, caval, inferior, with serialography, radiological supervision and interpretation) for the radiological venography of the varicocele if the patient hasn't already undergone this study. Append modifier 26 and modifier 52 (Reduced services) to 75825. You'll need to use modifier 52 because the urologist performed only a limited study of the vena cava.