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Cystoscopy, bladder dilation

  1. #1
    Default Cystoscopy, bladder dilation
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    Dx Bladder neck stricture p/c done Cystoscopy, bladder neck dilation...
    would code 52000 be used or 52260 however, patient doesn't have cystitis and 52000 doesn't seem as if it covers entire p/c? please help, thanks

  2. #2
    If you do choose to use the 52260, the 5200 would be included in that and you could not code them both together.

  3. #3
    i'm worried about using 52260 b/c patient doesn't have cystitis?
    does code 52000 include dilation? thanks

  4. Question 52260 curiosity
    I'm curious to know the answer to your question as well. We have just encountered this very thing at my facility. 52260 is for interstitial cystitis..... does this mean if the patient does not have interstitial cyctitis this code should not be used? If so,then what code is appropriate to include the dilation of the bladder??

  5. Default
    We also just had an encounter where the patient did not have interstitial cystitis but a cysto was done with bladder dilation. Has anyone figured out which code would be correct to use?

  6. #6
    Here is a link to an older article that may help:

    Hint: Code 595.1 isn’t the only medically necessary diagnosis

    CPT codes 52260 and 52265 specify interstitial cystitis in the description - and that’s the condition for which urologists are most likely to use it, says Heather Smolinski, CPC, coding specialist with Genito-Urinary Surgeons in Toledo, Ohio.

    But that doesn’t mean 595.1 is the only diagnosis code you can link to 52260 (Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction [spinal] anesthesia) and 52265 (… local anesthesia) and get paid, says Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 22-urologist practice in Indianapolis.

    “There is no requirement for a specific IC diagnosis code to bill 52260 and 52265,” he says. “Often these are done for patients in the course of ruling out IC and may be billed for the symptoms of IC.”

    Besides 595.1, acceptable diagnosis codes that support the medical necessity of 52260 and 52265 often include 599.7 (Hematuria), 788.1 (Dysuria) and 788.41 (Urinary frequency).

  7. Default
    thanks for the reply. that helps me out alot

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