Wiki Comparable code for Urolift

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umcanes4

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Hi. I was wondering if anyone had to submit any information to the insurance companies in 2014 for the unlisted codes for the Urolift procedure? This is my first one and I really do not see any other "comparable" code to the Urolift procedure itself.

the urolift procedure retracts the prostate tissue without cutting, heating or removing prostate tissue. All the codes the Urolift company gave us as similar procedures includes lasers, cutting or some type of thermotherapy.

Am I looking at this in the wrong way?

Thanks for any help! :)
 
Yes, we had to submit documentation and lots of it. We had to submit the operative notes, the Urolift "booklet" that describes in detail the procedure. We had to send the invoice for the implants as well as peer reviews on the Urolift. We got these from our rep. In some instances, we had to send the FDA approval letter as most insurances were still considering this experimental/ investigational.
Thankfully, 2015 we now have codes.

Nancy
 
Thanks Nancy!

Yes, I submitted all of that documentation but now our business office is stating they are requesting a comparable code. The only thing we can come up with is the cystoscopy but thats not really comparing it to the procedure. Ugh.. I dont agree with any of the other codes. Do you remember if you had to submit any information like that?
 
Look at 52441 Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant
and +52442 Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure)
 
Thanks KCROSS. This is my first time submitting information so I was going by what the Urolift company provided as possible comparable codes, which are:
52601, 52648, 52649, 52647, 53852, 53850, 52282, 52000 and 53855.

I didn't think or know we could use the 52441 because of them being new and effective this yr and this case is from 2014. I'm going to give that a try.

Thanks!
 
If I understand correctly, you are looking for codes to compare the unlisted code used in 2014 for Urolift; in our experience, we were told by some insurance companies to compare the unlisted code to 53855 and 52000. But, these claims are still being denied and we are aggressively appealing. If you visit the Urolift website they offer an abundance of info, documents and appeal letters for your review/use.

As you are aware codes for Urolift were established for 2015.
 
Old thread

KCROSS said:
Look at 52441 Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant
and +52442 Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure)
Click to expand...

I am billing for this procedure now. Am I reading this correctly that I use 52441, 52442 and then 52442 for each implant after the first 2? My doctor used 5 implants on one patient and 4 on another.
 
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