I see 52648 and 52204, 59.
Need opinion on cpt codes. I was looking at 52648 and 52234-51, but I got an edit in my system for 52648 (edit 3540) and 52234 (edit 3440), but when I put info into NCCI edits, it showed they were allowed. Totally confused what codes to use and confused aboaut the edits. ??????????? Any help would be appreciated. Thanks.
operation: cystoscopy, excisional biopsy of bladder tumor posterior bladder wall 2 cm and diode laser vaporization of remaining bladder tumor and diode laser vaporization of the prostate.
procedure: Cystoscopy revealed a normal urethra to the verumontamum. There was lateral lobe hypertrophy and obstructing middle lobe of the prostate. The bladder showed a 2 cm bladder tumor over the posterior bladder wall with no evidence of other tumors.
52204 (fulguration is included)-Using the excisional cup biopsy forceps, the lesion was biopsied and sent to pathology. The remaining area of bladder tumor and perimeter was easily coagulated and vaporized with 5000 joules of diode laser energy at 1470 nanometers with the flat head 0 degrees fiber. 52648-Attention was then directed to the middle and left lobe of the prostate and using 23,380 joules the flat-tipped fiber, the middle lobe was resected and specimen sent to pathology. No lateral lobe was directly vaporized. Using the side right angle laser fiber, the right lobe was vaporized and a total number joules on the middle and left lobe was 23,380 and total joules on the right lobe was 16,340 withe the right ankle fiber at 80 watts powers. The total number of joules used in the case was 40,020 joules. There was a nice wide-open prostatic fossa at the end of the case. The area of bladder tumor was clean with any bleeding. A 20-French two-way catheter was placed.
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