You Be the Coder:
Green-Light Laser Procedure
Published on Fri Aug 11, 2006
Reviewed on May 27, 2015
Question: My physician documented that he performed “photoselective vaporization of the prostate using green-light laser” for a patient with urinary retention. Should I code this using 52648?
California Subscriber
Answer: Although 52648 (Laser vaporization of prostate, including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed]) is an appropriate code for the green-light laser procedure, you have another problem.
Remember: The diagnosis indicating the medical necessity for the green-light laser procedure must be BPH with obstruction (600.01, Prostatic hyperplasia) For ICD-10, report N40.1 (Enlarged prostate with lower urinary tract symptoms). Urinary retention (788.20, Retention of urine, unspecified) or in ICD-10 R33.9 (Retention of urine, unspecified) is not considered a viable diagnosis that proves medical necessity for the green-light laser procedure. Therefore, payers will likely deny your claim based on that diagnosis.
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