TURP terminated - This patient is here for TURP

[lbarbar]

Hello,

This patient is here for TURP …. But only cystourethroscopy was done due to failed attempt to bypass bladder neck …..

Operation note:
Under Spinal Anesthesia
Cytsoscope was inserted till bladder neck
Could not pass the scope beyond a fibrotic prostate and high bladder neck
Trial of resectoscope insertion also failed to bypass the bladder neck area
Procedure terminated
18 Fr 2-way Foley's catheter was inserted


My questios is:
Should I code 52601 for TURP with modifier 52 as the operation was not completed? Or I should only code cystourethroscopy (52000) ???

Thank you

 

[lbarbar]

any sugestion?

 

[Lainie0559]

I would code it as 52601-53 and then add a text line "unable to pass resectoscope past bladder neck".

 

[michelleaapc2012]

I have experienced this before and used 52000 because that is all that was actually performed.