Wiki is 52281 for "through the scope"

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mommacode

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If patient does have urethral stricture, and sound dilation is performed "prior to" the cystoscope being inserted is it appropriate to code 52281 or is this code only appropriate for "through the scope" dilation????
 
Here is a Urology Coding Alert from 5/19/2017 that will clear up this issue:

"Question: A patient had a pre-existing pathological urethral stricture. The physician dilated the urethral stricture then inserted the cystoscope to examine the urethra and the bladder. Because he performed the dilation before inserting the cystoscope, is the correct CPT® code 52281? Or should we bill only 52000 because 53600 for the dilation is bundled with 52000?

North Carolina Subscriber

Answer: Based on the documentation provided, the most appropriate code is 52281 (Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female) because it includes both the dilation of the pre-existing stricture and cystoscopic examination. There’s no need to report separately 52000 (Cystourethroscopy [separate procedure]) or 53600 (Dilation of urethral stricture by passage of sound or urethral dilator, male; initial)."

Drew Vinson
CPC
NW Urology
 
CodingKing said:
NCCI bundles 52281 into most if not all other transuretheral procedures, with no modifier allowed to bypass the edit.
Click to expand...

yes, 52281 wouldn't be coded with 52281 or the dilation code but what I am asking is 52281 coded only when the dilation is performed "through" the scope?

If the scope is inserted and then removed and then the dilation is performed are we still to code 52281 when the scope has been taken out?
 
If your doctor does dilation and cystoscopy during the same session, then code 52281. This is true even if the dilation was not done through the scope.

CPT 53600 is only reported in those cases where the doctor does a dilation, but does not do cystoscopy during the same session.

Sincerely,

Drew Vinson
CPC
NW Urology
 
drewvinson23 said:
If your doctor does dilation and cystoscopy during the same session, then code 52281. This is true even if the dilation was not done through the scope.

CPT 53600 is only reported in those cases where the doctor does a dilation, but does not do cystoscopy during the same session.

Sincerely,

Drew Vinson
CPC
NW Urology
Click to expand...

Drew- Do you have any documentation to support that. I was told that is the dilation is done first and then scope inserted you would not code 52281.
Thank you

Report reads" The genatilia was prepped and draped in the usual fashion. The urethra was then dilated with the female dilators to a caliber of 30 French. The 25 French cystoscope was then placed inside the bladder.

No mention of any stricture or anything else.

Appreciate all your help and guidance.
 
If you look at my initial post, this says "the physician dilated the urethral stricture then inserted the cystoscope to examine the urethra and bladder." This is from an AAPC Urology Coding Alert.

For further evidence, you can check out this site:

https://www.audioeducator.com/archi...and-uncomplicated-urethral-foley-passage.html

If you notice here, they say, "For instance, we have a patient that is undergoing cystoscopy and urethral dilation. Now, when you do a cystoscopy and urethral dilation, this combination and in any sequence of cystoscopy and urethral dilation...use the code 52281."

Hope this helps,

Drew Vinson
CPC
NW Urology
 
Is cpt 52281 appropriate when only a cystoscope is used to dilate the urethra? No dilators, filliforms, or followers were used, ONLY the cysto orbutrator. Or is 52000 the better code to use?
 
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