Wiki NCCI codes

[1CodingTeam24]

Question: if we have CPT codes that maybe considered inclusive of the primary procedure 50590 ESWL, Do we still list all CPT codes on the claim regardless or do we exclude the codes considered inclusive based on the NCCI edits? Example of codes below.

• 50590 / LT
• 52332 / LT
• 52005 / LT
• 52330 / LT

 

[sls314]

Question: if we have CPT codes that maybe considered inclusive of the primary procedure 50590 ESWL, Do we still list all CPT codes on the claim regardless or do we exclude the codes considered inclusive based on the NCCI edits? Example of codes below.

• 50590 / LT
• 52332 / LT
• 52005 / LT
• 52330 / LT

As a general rule, you don't want to unbundle services. If the service is fully captured in another code, then you would use that.

In the scenario above, you've listed CPT codes for lithotripsy, 2 different cystourethroscopy CPT codes, and a temporary catheter code.

I'll preface this by saying that I'm not a urology coder. I'm just pulling information from the Urology chapter of the NCCI manual: https://www.cms.gov/files/document/07-chapter7-ncci-medicare-policy-manual-2026-final.pdf

However, I'm curious why you're using separate codes for the lithotripsy and the cystourethroscopy on the same ureter, when according to the NCCI manual there seems to be a code that combines cystourethroscopy with lithotripsy:






Additionally, the 52005 can never be reported with the 52332 for the same ureter on the same patient encounter per the NCCI manual: