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Procedure performed TURBT, large (greater than 5 cm), bilateral. In actual procedure it states one large and one medium. The findings state two medium. Isn't the findings the information after the procedure or based on a test done?
From the CMS Claims Processing Manual, Chapter 12, Physician/Nonphysician Practitioner:
B. Cystourethroscopy With Fulgration and/or Resection of Tumors (Codes 52234,
52235, and 52240)
The descriptors for codes 52234 through 52240 include the language “tumor(s).”
This means that regardless of the number of tumors removed, only one unit of a single
code can be billed on a given date of service. It is inconsistent to allow payment for
removal of a small (code 52234) and a large (code 52240) tumor using two codes when
only one code is allowed for the removal of more than one large tumor. For these three
codes only one unit may be billed for any of these codes, only one of the codes may be
billed, and the billed code reflects the size of the largest tumor removed.