prostatectomy procedures

jcrahan13

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Can anyone explain the differences between the prostatectomy procedure codes, 52601, 52647, 52648, and 52649? the surgeons in my practice seem to use certain terms interchangeably and it becomes confusing as to the technique that should be coded
 

nickelclaw

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Peru, IN
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52601 (the first time) evacuation of chips will be noted, is electro-surgical, rectoscope used (TURP) 52630 (2nd time or anytime after) no matter time frame RECURRENT OR RESIDUAL REGROWTH OF TISSUE

These an endoscope or rectoscope will be used to laser coagulate, vaporize, or enucleate
52647 coagulate
52648 vaporized
52649 enucleated may see the word "morcellation"
Hope this helps:)
 

jcrahan13

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This pt has never had a TURP performed before however, this is what the op note reads,
"The button plasma electrode was attached. Using normal saline irrigation as well as bipolar current, a vaporization procedure was started by removing the median lobe at the 12 o'clock position and going down to the bladder neck. The lateral lobes then vaporized going back to the apex where care was taken to avoid going past the verumontanum. A large amount of tissue was vaporized and an open channel was created."

Because this patient has never had this kind of procedure performed do I code it as 52601? or is this a vaporization procedure 52648?
 
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Vaporization via an electric current would be coded 52601. Vaporization via laser technology would be coded 52648. Reading the CPT definitions of each procedure in the CPT manual should be helpful to you.
 
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