Urology Help Needed

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I need help with Urology coding. I'm new to Urology, and am trying to learn this.

The doctor did a Lithotripsy on an ureteral stone and on a kidney stone. Both stones were on the left side. The patient has Medicare. Can this Lithotripsy be billed separately for each stone, or is the second one bundled since it's on the same side?
 

Venkatakrishnan

Networker
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Chennai, Tamil Nadu
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Hi Jforster,

Coding of lithotripsy with one unit is correct (if ureteroscopically done use CPT 52353 / if Extracorporeal Shockwave was used, use CPT 50590)

Thanks,
Vernon Kreiss
 
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Here's what he has listed on the OP report:

"Cystourethroscopy
-Ureteral Stent Removal, Left Side
-Stent location: Bladder
-Complexity: simple


Ureteroscopy
-Ureteral Stone
-Left Side
-Laser Lithotripsy


Ureteroscopy
-Renal Stone
-Left Side
-Laser Lithotripsy


Cystourethroscopy
-Ureteral Stent Placement
-Left Side"

I was going to code 52356, 74425,26, but he thinks we can bill the Renal Lithotripsy separately. I was under the impression it was bundled since it was on the same side. <-- I did see several articles saying you can bill 52352 for the Renal since there is no CCI edit saying you can't bill 52356 and 52352 together, but I'm torn as to whether that's really correct. It seemed like everything I read on that was about 50% pro billing 52352 and 50% opposed to billing 52352. I also did not code the stent removal since he inserted a new stent.

Will someone please give me their opinion???!?!??!??!?
 
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