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Urology coding

  1. Cool Urology coding
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    I am coding for an asc and the urology surgeries are giving me trouble...

    The op report says:
    Operations performed:
    Cystoscopy 52351-bundled
    laser lithrotripsy with staone manipulation 52353
    placement of a 6 x 24 percuflex stent 52332
    transurethral incicion of ureteral orfice to get the whole stone out and removal from the bladder. ????52305?????

    So the problem is this.. Is 52305 the correct code or is this bundled?

    The op report goes on to say......this revealed a normal urethral and normal trigone except the left hemitrigone was elevated. There was a stone at the orfice. We coild not get a wire to go or open catheter. Using a ureteroscope we went right up against the stone and using a laser stone was fragmented some pieces off of it, but the stone failed to do much except we were able to clear an where i was able to get a wire up for access. One wire was up, we used a cystoscope and tried to laser it but was an awakard angle so i backed out and used a iglesias element with collins knife and 30-degree lens. We made an incision into the ureteral orfice and the stone popped out. At that time we re entered the catheter and using flexible utereoscope went all the way into the kidney and identifed no further stones.

  2. Default
    I am interested in how you ultimately coded this.
    Last edited by dessart; 08-24-2010 at 09:50 AM.
    Jerry Dessart

  3. #3
    52305 is for treatment of the female urethral syndrome with incision or resection of bladder diverticulum, so I don't think that code is appropriate. Once a procedure becomes an "open" procedure that is the code that should be used. Have you looked at maybe 51050? Since the cystourethroscopy with lithotripsy was attempted could you use 52353 with modifier 52? I would consider the placement of the stent integral to the cysto and removal of the stone. Anyone else have any ideas on this one?

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