Ah, I just found this on the Urology Times website:
Q In a case where it is necessary to dilate a patient in order to insert a cystoscope, we have been told that we can bill code 52281 (Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female) instead of 52000 (Cystourethroscopy, separate procedure). Is this correct?
A The short answer is no, this is not correct. The description of 52281 as read above includes specific language indicating why the dilation is performed. Therefore, a patient who does not have a clearly documented stricture or stenosis of the urethra should not be billed for code 52281. Dilating the urethera for insertion of the cystoscope for a reason other than a stenosis or stricture is considered to be part of the procedure, and therefore should not be separately reported.
On the other hand, the code does not stipulate the method of dilation for those who have a stricture or stenosis. Thus, a patient who has one of these diagnoses and is dilated with a sound or filiforms and followers prior to cystoscopy should be reported under code 52281
Why could I not find any info on this until right after I write a long drawn out post?
Does this sound right to you experienced urology coders out there?
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