trinalankford
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I have conflicting info here.
I have a Coding Brief from the American Urological Association, stating that CPT 52353 (cysto with ureteroscopy and/or pyeloscopy with litho) and 52332 (cysto with stent placement) have been combined to one CPT code of 52356 (cysto with ureteroscopy and/or pyeloscopy, with litho and placement of stent) WHEN PERFORMED AT SAME SETTING.
However, NCCI Edits say 52353 and 52332 can be billed together. Medicare is paying this combo....but commercial payors are not, saying the stent is inclusive to the 52353.
My question is...how can Medicare be paying by NCCI Edits and commercial insurers not...and why is Medicare paying when apparently 52356 should have replaced the combo?
Does any of this make sense? Good grief. Thanks for your help!
I have a Coding Brief from the American Urological Association, stating that CPT 52353 (cysto with ureteroscopy and/or pyeloscopy with litho) and 52332 (cysto with stent placement) have been combined to one CPT code of 52356 (cysto with ureteroscopy and/or pyeloscopy, with litho and placement of stent) WHEN PERFORMED AT SAME SETTING.
However, NCCI Edits say 52353 and 52332 can be billed together. Medicare is paying this combo....but commercial payors are not, saying the stent is inclusive to the 52353.
My question is...how can Medicare be paying by NCCI Edits and commercial insurers not...and why is Medicare paying when apparently 52356 should have replaced the combo?
Does any of this make sense? Good grief. Thanks for your help!