Wiki Litholapayx 52317 vs 52318

[GailKeiser]

The description of these codes state: ; simple or small ( <2.5 cm) or complicated or large ( over >2.5 cm)

Do you code of the path report sizes if not stated by the MD?

Do you code by simple and what would be the definition of simple? or Complicated and its definition?

Query the MD for the size of the stone if it is not documented?

 

[TammyHF]

Technically you need the size of the largest stone documented by the physician in the operative report or why the procedure was complicate such as bladder stone is location in a bladder diverticulum making the case more complicated. You wouldn't want to use the size of a bladder stone from pathology because the bladder stone would have been crushed as part of the removal per CPT guidelines for the code.