Urology Coding Alert

Question: Should I use a code for transurethral resection of the prostate (TURP) and append modifier   -52 (Reduced services) for a transurethral resection of only the ejaculatory ducts?
      
Connecticut Subscriber

Answer: The code you are looking for is CPT 52347 (Cystourethroscopy with transurethral resection or incision of ejaculatory ducts).
 
You are correct that your urologist should not receive the same amount of reimbursement as he would for a full transurethral resection of the prostate, but the reduced-services modifier on the TURP code (52612, Transurethral resection of prostate; first stage of two-stage resection [partial resection]; and 52614, ... second state of two-stage resection [resection completed]) would not properly represent his services.
 
Check the operative documentation to determine whether you should code for any additional services that may accompany the transurethral resection of the ejaculatory ducts.
 
These additional services may include CPT 52010 (Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service) and 55300 (Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral).
 
And if your urologist documents interpretation of the radiological findings, use 74440-26 (Vasography, vesiculography, or epididymography, radiological supervision and interpretation; professional component).