52640 once in a lifetime code????

[Jessim929]

Hi -

I have a patient who had a TURP with a TUIP in 2013. He had a resection of the bladder neck contracture on June 23rd of this year, because of the TURP, I billed 52640. Medicare is denying it for frequency. Did I miss something?

Thanks in advance!

 

[SharonCollachi]

Did you look at 52400?

 

[sxcoder1]

I have never heard of 52640 being once in a lifetime.

 

[Jessim929]

Did you look at 52400?

But he didn't correct a defect. He flat out resected tissue from the bladder neck to open it up.

 

[Jessim929]

I have never heard of 52640 being once in a lifetime.

Me neither. I knew 52500 was, and it was only if there was no previous surgery. But this was new to me. I'm thinking Medicare went wacky.

 

[sxcoder1]

I did not know about 52500. I do know that 52601 is.

 

[SharonCollachi]

But he didn't correct a defect. He flat out resected tissue from the bladder neck to open it up.

Sorry, I was looking at the wrong thing.

 

[Jessim929]

Sorry, I was looking at the wrong thing.

No worries. I was hoping it was somehing I didn't consider before!

 

[liqgold2@aol.com]

I believe 52640 is as stated the correct code for your clinical scenario. However, there seems to be a frequency problem where this code cannot be billed a second time. I would then consider 52500 with a diagnosis of N32.0