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52005-do you apply LT and RT?

  1. #1
    Location
    York, PA
    Posts
    60
    Default 52005-do you apply LT and RT?
    Medical Coding Books
    When coding a cysto with retrograde pyelogram, left and right, do you apply 52005 LT and 52005 RT? Thank you.

  2. #2
    Location
    High Point, NC
    Posts
    84
    Default
    CPT 52005 should not be billed with LT or RT modifiers as there are no paired organs for this CPT. You should also be able to bill the professional component of the retrograde with CPT 74420-26.
    Cindy Gallimore, CPC, CENTC

  3. Default
    We were billing 74420/26 for our urology doctor reading the RPG, but were told we cannot bill for this at all in the hospital setting, as the hospital bills for the technical component and the radiologist who reads the report bills for the professional component. Unless the urologist is the one signing the final report, I don't think 7220/26 can be billed.

  4. #4
    Location
    High Point, NC
    Posts
    84
    Default
    If your Urologist is interpreting the retrogrades during the procedure and documenting this, you should be able to bill the professional component of the retrogrades. Your provider is doing the S&I of the procedure. It may depend on what the hospital is billing. We have one facility here that the provider bills the professional component & the hospital bills the technical component and then we have another facility where the hospital bills the global fee regardless. You may want to check with your facility to find out how they are billing it.
    Cindy Gallimore, CPC, CENTC

  5. #5
    Default Bilateral retrogrades
    So for bilateral retrogrades, is it 52005 and 52005-51?

  6. #6
    Location
    High Point, NC
    Posts
    84
    Default
    You can only bill 52005 once (& 74420-26 if your facility let the Urologist bill the professional component).
    Cindy Gallimore, CPC, CENTC

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