Wiki Urolift & button vaporization of prostate

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umcanes4

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Good morning.. hoping someone can shed some light on this procedure. Its our first one and we have conflicting codes..


Procedure Name:
Elective Cystoscopy, urolift procedure, button vaporization of the prostate.

Procedure Description:
Pt was taken to the OR and induced under general anesthesia. Pt was repositioned in dorsal lithotomy position and then cystoscopy performed. Cysto revealed 40-50gm prostate w/ trilobar hyperplasia, gr 2 bladder trabeculations. At this time the urolift scope was inserted and the urolift device deployed 5 times: one on each side of the prostate 1-2 cm proximal to the bladder neck, 1 on each side of the lateral lobes just distal to the verumontanum, and then one addition in the right lateral lobe. A nice open channel was created from the verumontanum to the bladder neck. The button vaporization bipolar fulguration was used for hemostasis. The bladder was partially filled and then the scope removed.

Some have 53899, 55899 & 52000 and then we have another with using the 52601 because they found info stating us 52601 also for the bipolar "button" electrode electrical vaporization of the prostate gland.

Any help would be appreciated :) Thank you!
 
We use 52601. I found some supporting documentation online.


Question: My urologist is performing a new procedure called a "button TURP." I thought CPT 52601 or CPT 53852 might be correct, but now I'm thinking an unlisted procedure code may be more appropriate. What code should I use for this procedure?

California Subscriber

Answer: You should report 52601 (Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included]) for the button transurethral resection of the prostate (TURP) procedure.

Why: The button TURP is a bipolar electrical vaporization of the prostatic adenoma with a button appearing electrode. Several years ago there was another procedure using a ball type electrode to electrically vaporize the prostate. This instrument was called a Vaportrobe. At that time, coders were instructed to bill for the Vaportrobe using 52601 as this was an electrical procedure. Likewise, you should now use 52601 for a "button TURP."

Pitfall: While the button TURP procedure resembles a laser treatment, it is not a laser vaporization. Therefore, you should not use 52648 (Laser vaporization of prostate, including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed]) or 52649 (Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed]). Also remember that this procedure is not radiofrequency thermotherapy, therefore, 53852 (Transurethral destruction of prostate tissue; by radiofrequency thermotherapy) is not the appropriate code to report either.
 
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