AAPC - Back to school
Results 1 to 3 of 3

Thread: Cysto coding help

  1. #1

    Default Cysto coding help

    AAPC: Back to School
    Please take a look at this op report, and let me know what codes you would use.

    The patient is an 86-year-old white female, quite debilitated
    with known significant peripheral vascular disease, who was seen
    in the hospital in October 2009, with right hydronephrosis
    secondary to large nonopaque stones. A right double-J stent was
    placed on an emergent basis at that time. She has done well and
    was scheduled for replacement of the stent presently. Definitive
    treatment of the stones radiolucent in the right kidney have been
    deferred due to her medical status and the limited options for
    treatment of the large radiolucent stones. Plans at this time
    were for her to have the double-J stent replaced.

    The patient was taken to the operating suite. She was placed in the
    lithotomy position dorsally with some difficulty due to the fact
    that she does have a left AK amputation. Cystoscopy was
    performed showing no intravesical lesions. The right double-J
    stent was identified. The entire portion of the visible stent
    was totally calcified. Photos were obtained. With some
    difficulty the distal portion of the stent was grasped and pulled
    to the urethral meatus. The lumen and distal portion of the
    stent could be seen due to the nature of the entire calcified
    stent. This was not appreciated on previous films because of the
    radiolucent nature of the stone.
    Fragmentation of the stone was carried out in the bladder
    manually and the lumen was identified, however no wire, either
    rigid or flexible, could be passed into the distal portion of the
    stent suggesting total occlusion of the indwelling stent. Thus,
    an open-ended catheter was placed adjacent to the stent in place
    and a retrograde pyelogram was then done, showing no evidence of
    extravasation of the collecting system and no ureteral injury.
    An 0.038 Glidewire was then placed into the right renal pelvis
    and a second double-J stent, 26 cm 7-French, Optima stent, was
    then placed into proper position radiographically and visually.
    Upon completion of the procedure, the bladder was then drained.
    A #18 Foley catheter was left in place. The patient was taken
    to the operative suite to the recovery room, having tolerated the
    procedure well.

    For ICD-9 codes, I am looking at 274.11, 591, and 996.64(?).
    CPT codes: 52315 or 52318

    Any help would be greatly appreciated.

  2. #2


    How was the stone fragmented? I'm thinking 52317 and 52332.

  3. #3


    Thank you for your help. I agree with the 52332, however I was leaning towards the 52318 vs. 52317 because of patient's age and difficulty. I do not have any additional information about the fragmentation of the stones. Again, thanks for your input.

Similar Threads

  1. E/m and cysto
    By cheyenne102 in forum E/M
    Replies: 0
    Last Post: 08-20-2013, 01:37 PM
  2. cysto
    By turnerdc@gmail.com in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 11-02-2012, 03:59 AM
  3. Coding Help Please for Cysto
    By Sunny0967 in forum Urology
    Replies: 1
    Last Post: 10-22-2012, 09:54 AM
  4. Help with CPT coding for Cysto with placement
    By Jody Mortensen in forum Urology
    Replies: 2
    Last Post: 11-30-2009, 11:06 AM
  5. Cysto/Stent Coding Question
    By ksamples in forum Urology
    Replies: 3
    Last Post: 04-14-2009, 10:45 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.