Wiki 00910 / 00918 versus 00862

[vmidla]

Wondering if anyone is coding cystourethroscopy procedures that have the alternative crosswalk choice of 00862, such as CPT codes 52332 or 52356. This is coming up in discussion, due to
00862 is given in as a choice in the crosswalk but when you read the RVG Comment under 00862, it states, "For anesthesia for transurethral cystoscopic procedures, see codes 00910 through 00918"

 

[solocoder]

I have been wondering the same thing. So, transurethral procedures such as 52356 or 52332 will still use crosswalk codes 00910 - 00918?

 

[vmidla]

Yes, per the crosswalk the primary code is 00910 or 00918 but the alternate code choice is 00862 for both CPT codes. Seems the codes are in a loop because if you want to select 00862 from the crosswalk and then refer to the RVG for 00862 it states to code 00910 and 00918 for transurethral procedures.

 

[solocoder]

Yes, per the crosswalk the primary code is 00910 or 00918 but the alternate code choice is 00862 for both CPT codes. Seems the codes are in a loop because if you want to select 00862 from the crosswalk and then refer to the RVG for 00862 it states to code 00910 and 00918 for transurethral procedures.

Anyone know what would be some examples of when we WILL use 00862? I saw this from 2009 which makes it sound like 00862 could be used with 52356 if the calculus is in the kidney or upper ureter.

 

[jodielonkoski]

Here is an AAPC article that discusses this!

"
The ASA Crosswalk lists 00918 (Anesthesia for transurethral procedures [including urethrocystoscopy]; with fragmentation, manipulation and/or removal of ureteral calculus) as the primary anesthesia code for procedures 52352-52355 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy ...), but don’t make that your automatic choice.

Notes below each code from 52352-52355 state you should report 00862 (Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy) when lithotripsy involves the kidney or upper one-third of the ureter. Because of this “upper one-third” distinction, you’ll need a copy of the operative report to code accurately.

Many coders gauge their anesthesia code selection by the stones’ location. For example, for excision of a stone, the coder will submit 00910 (Anesthesia for transurethral procedures [including urethrocystoscopy]; not otherwise specified) for a bladder stone, 00918 for a ureter stone, and 00862 for a kidney stone."

https://www.aapc.com/codes/coding-newsletters/my-anesthesia-coding-alert/reader-questions-pinpoint-stone-location-to-narrow-anesthesia-code-choices-171434-article

 

[jodielonkoski]

Following up because I emailed the ASA crosswalk asking on this. I specifically had asked in regards to 52332 and 52356 which is why they focused on those in the reply. So sounds like it may not be an alternate for 52332 next year but otherwise is applicable if the scope/work is done in upper 1/3 of the ureter or kidney, and includes the transurethral approach.

"
For any procedure on the "upper one third of the ureter" the most specific, and therefore correct, CPT code would be 00862 regardless of whether the approach was open, percutaneous, or using fiberoptic guidance from the lower urinary tract. 00918 would apply to procedures involving calculi of the distal 2/3 of the ureter. 00910 would apply when the ureters are not involved at all in the procedure.



The CPT definition of 52356 is "Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent." Thus, this procedure necessarily involves the ureter but may or may not involve the proximal 1/3 of the ureter. The appropriate crosswalk would be 00918 or 00862 depending on the where in the ureters the work was performed.



52332 is "Cystourethroscopy, with insertion of indwelling ureteral stent." It should not normally involve any part of the ureters and thus 00910. 00862 implies incision or scope not through the urethra. We will flag this for the editorial board for clarification in the 2027 version. "