We've had patients come in for a lithotripsy only to find on the fluoro that the stone is no longer present, thus coded as a 50590-73, discontinued prior to anesthesia.

The doctors now want to do a “dry run” with the litho machine which involves bringing the patient in to see if the stone is still there using the litho machine. If it is, they are then brought back to have the procedure done at a later date. My supervisor said they are thinking this is more of a diagnostic procedure and they have told them they are not allowed to do them there. The urologist told them they are doing them at other centers and charging a nominal fee.

I was told using the litho machine to see if the stone is present uses an x-ray. Would I also code this as strictly an x-ray of either the kidney, ureter or bladder (depending on the location of the stone) since they have no intention of performing the litho at this time (thus making 50590 not appropriate)? And coming in for only an x-ray wouldn't be appropriate for an ASC, correct? Any opinions would be greatly appreciated.

Thank you!