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Wiki 52355, 52332, 52354-51, 52353-51

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klen

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Surprise, AZ
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My doc billed 52355, 52332, 52354-51 and 52353-51. Medicare denied 52332 and 52354-51 as "this procedure or procedure/modifier combination is not compatible with another procedure provided on the same day. I identified the CPT guideline which states not to report 52332 in conjunction with 52353, but I am unable to find any guideline which would indicate 52354-51 is bundled with another procedure and I believe the modifier is appropriate. Any help would be appreciated.
 
52355 includes 52354 (a biopsy would be included with the resection), and instead of 52353 and 52332, you should have billed 52356 which is lithotripsy with stent.
 
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