They did not crush or fragment the stones (or if they did, it was not documented), so 52317 is not appropriate. So 52310 or 52315 are the choices that are left, I believe.
From "The Urology Place", 2019:
CPT 52310 Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple
CPT code 52310 describes the work of removing an indwelling ureteral stent by cystoscopy, when the stent is visualized then grasped using a grasping instrument to remove the stent. This procedure can be performed in the office, ambulatory surgical or hospital setting. The code requires and includes performing a complete cystoscopy (CPT 52000), which cannot be billed separately, and therefore documentation should include the results of an examination of the urethra (such as for strictures), the prostate (in men) and the bladder (such as for mucosal lesions, neoplasms or stones). CPT code 52310 is also the code used for simple removal of bladder stones or a bladder foreign body. The description of work involved includes the possible need for multiple passes into the bladder by stating: “Re-introduce the scope and remove the next, and all subsequent, stones in similar manner, until all stones have been removed. Re-introduce the cystoscope and inspect the bladder to assure no perforations or bleeding, then empty the bladder completely and slowly withdraw the cystoscope. If appropriate, insert a urinary catheter for postoperative drainage.” Due to this wording, CPT code 52310 would be billed once even for bilateral ureteral stent removal, and no modifier should be used in an attempt to bypass the edit.
CPT 52315 Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated
CPT code 52315 specifically describes the complex removal of an encrusted stent. Documentation should include the need to perform “twisting/torquing movement to try and dislodge some of the encrusted material from the stent” to qualify for CPT 52315. Similarly, the provider may “Re-grasp the stent as often as necessary to try and remove the visible stone material, with the goal of atraumatically removing the stent intact from the ureter. Use fluoroscopy to monitor the progress of the stent as you slowly withdraw it from the kidney. Re-introduce the cystoscope, inspect the bladder, assure that there is efflux from that ureteral orifice, and irrigate the bladder using a Toomey syringe until all of the stone material has been removed.” This code should not be used for the removal of an encrusted stent that is easily removed, nor for the removal of bilateral stents; CPT code 52310 should be used for those instances.
