CCANTER
Networker
I am wandering if i can bill 52344 with 52332. or if i should only bill 52351 with 52332. There are no CCI edits with 52344 and 52332 together. however i am questioning if i can bill the dilation since it was performed to enable the stent placement
here is the note
A 22 Fr rigid cystoscope was inserted per urethra and advanced into the bladder under direct visualization.
Panendoscopic inspection of the bladder demonstrated no mucosal lesions, masses, or concerning findings. The right ureteral orifice was identified in orthotopic position.
A sensor wire was advanced into the right ureter under fluoroscopic guidance. A retrograde pyelogram was then performed demonstrating a narrowed distal ureter with significant upstream hydroureteronephrosis and tortuosity.
A semirigid ureteroscope was advanced into the distal ureter.
This demonstrated a dense distal ureteral stricture approximately 5 mm in length. There was no visual evidence of urothelial tumor or intraluminal pathology. The stricture appeared benign in nature.
The working wire was maintained in position and serial ureteral dilation was performed using 8/10 French dilators over the wire to traverse the strictured segment. Following dilation, the wire was advanced into the renal pelvis and appropriate positioning was confirmed fluoroscopically.
Given the presence of obstruction and associated hydronephrosis, a 6 x 24 cm Tria firm ureteral stent was advanced over the wire and deployed with appropriate proximal and distal coil formation confirmed fluoroscopically and cystoscopically.
here is the note
A 22 Fr rigid cystoscope was inserted per urethra and advanced into the bladder under direct visualization.
Panendoscopic inspection of the bladder demonstrated no mucosal lesions, masses, or concerning findings. The right ureteral orifice was identified in orthotopic position.
A sensor wire was advanced into the right ureter under fluoroscopic guidance. A retrograde pyelogram was then performed demonstrating a narrowed distal ureter with significant upstream hydroureteronephrosis and tortuosity.
A semirigid ureteroscope was advanced into the distal ureter.
This demonstrated a dense distal ureteral stricture approximately 5 mm in length. There was no visual evidence of urothelial tumor or intraluminal pathology. The stricture appeared benign in nature.
The working wire was maintained in position and serial ureteral dilation was performed using 8/10 French dilators over the wire to traverse the strictured segment. Following dilation, the wire was advanced into the renal pelvis and appropriate positioning was confirmed fluoroscopically.
Given the presence of obstruction and associated hydronephrosis, a 6 x 24 cm Tria firm ureteral stent was advanced over the wire and deployed with appropriate proximal and distal coil formation confirmed fluoroscopically and cystoscopically.