Wiki multiple endoscopic injections to different sites -NEW UROLOGY CODER NEEDS HELP

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jocarter

jocarter

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I am new to Urology coding and an getting stuck on a record. I would greatly appreciate any recommendations on this.

The provider did a cystoscopy, detrusor injection of botulinum into the bladder and then also did periurethral submucosal prostatic injection of Macropastique.

in my mind we would code 52287 for the cystoscopy with botulinum injection into the bladder, and
also code 51715 for the macropastique injections.

The botulinum injections were to the bladder and the macroplastique was injected into the prostatic fossa (between the bladder and penis)

My logic is that the injections are in seperate locations so both codes should be billable....

Does anyone else have a different outcome on this scenario?

Thank you,
Jolene
 
CPT 5287 is a Column II code for 51715 that can be broken by usage of an appropriate modifier. Hopefully you have two different diagnoses to support medical necessity the need of each procedure.
 
Something about the 52287 that you should be aware of:

Many insurance companies, including Medicare have certain dx codes that have been approved for the Botox/cysto. These are para/hemiplegia, Cauda Equina, Multiple Sclerosis etc. Many other dx codes, such as OAB, NGB can be denied for necessity. You will need to appeal if this code denies
 
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