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Thread: Cystolitholapaxy question

  1. #1
    Join Date
    Apr 2007
    Bangor, Maine

    Default Cystolitholapaxy question

    AAPC: Back to School
    I have a very brief op note description for

    1. Cystolitholapaxy
    2. Placement of right double-J ureteral stent
    3. Shockwave lithotripsy to right renal calculi

    Cystourethroscopy was notable for finding several small stones within the bladder and these were broken up and manually removed using a manual grasper. We did this until the bladder was free of stones. Over a guidewire, a double-J uretal stent was inserted into right kidney. The patient was then repositioned on the medispec EM1000 lithotripter so the two right renal stones were sequencially placed at the F2 focal point. We delivered 4200 shocks to two areas of stone. Intermittent flouroscopy was utilized to ensure the areas of stone were maintained at the F2 focal point. The stones then suggested some comminution and the patient was transferred to recovery.
    The codes I have so far are 50590 and 52332. I want to add the 53217 for the manual break up of the stones in the beginning. Is that correct or am I way off?
    Leslie, CPC

  2. #2
    Join Date
    Apr 2007
    Albany, New York


    Your code choices are good, but I think you mean "52317", not 53217.
    Karen Maloney, CPC
    Data Quality Specialist

  3. #3
    Join Date
    Apr 2007
    Bangor, Maine


    Yes, I did...thank you So you would use all three codes also?

  4. #4


    Your right in your codes with the 52317.

    50590 592.0
    52317-51 594.1
    52332-51 592.0

    Are you billing the PC for the fluro? Some pay, some don't. You don't bill Medicare and Medicaid.

    Liz, CPC, CMC, CMSCS

  5. #5


    I would bill like Liz did but would include
    76000-26 (if you doc performed the test only)

  6. #6

    Default bundling?

    Please remember to check your bundling before you submit the code selection. I cannot recall, but I thought 52332 and 52317 were bundled, but like I said, I cannot recall off the top of my head.

  7. #7
    Join Date
    Apr 2007
    Bangor, Maine

    Default bundling

    Thanks all! I will check the CCI for that issue. And I did code for the flouroscopy

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