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New Coder/Too Old Coder

  1. Question New Coder/Too Old Coder
    Exam Training Packages
    I am trying to brush back up on urology coding which I haven't done for 15 years. I'm working with a new young coder who isn't certified and has been coding (with the doctor's assistance) for only a few months. Will you please look at the (planned staged) procedures below, and tell me how you would code them? Thanks!

    6/29 DOS: Cystoscopy, right retrograde pyelogram, right ureteroscopy, laser lithotripsy of stone, basket extraction of stone, insertion of right 6x26 double J ureteral stent.

    Same Patient/Next procedure:
    8/2 DOS: Removal of stent (from prior procedure), Cystoscopy, right retrograde pyelogram, right ureteroscopy, laser lithotripsy of stone, basket extraction of stone, insertion of right 6x26 double J ureteral stent.

    Your input will be GREATLY appreciated!

  2. Default
    DOS 6/9

    CPT 52353 , Cystouretero w/lithotripsy
    CPT 52332, Cystoscopy and treatment STENT
    retrograde pyelogram- CCI edit is inclusive to the 52353. If the provider interpereted you can bill the 74420 Contrst x-ray for the retrograde pyelogram, urinary tract, with the 26 modifier.

    The 52353 and 52332, global days according to CMS 000, no gloabl days.

    DOS 8/2

    52310-78 (78 modifier may not be needed, this is not with in the global period) but is planned.
    CPT 52353 , Cystouretero w/lithotripsy
    CPT 52332, Cystoscopy and treatment STENT
    retrograde pyelogram- CCI edit is inclusive to the 52353. If the provider interpereted you can bill the 74420 Contrst x-ray or the retrograde pyelogram, urinary tract, with the 26 modifier.

  3. Default
    Thank you!! VERY HELPFUL!

  4. Default Urology/Nephrology Coding Companion
    I find this book by Ingenix very helpful. It gives you CCI edits, coding tips. Medicare edits, Medicare follow up days, and diagnosis codes that support medical necessity. It also gives you a lay description of the procedure. I also prefer the CPT Expert when you order your new book for 2011. It gives helpful hints about procedures that can be billed separately when performed with another procedure. I have also used the book when fighting with insurance companies for additional payment. I hope this helps.

    Cheryl Powell, CPC

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