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Thread: extracorporeal shockwave 50590 x 3 same DOS

  1. #1

    Default extracorporeal shockwave 50590 x 3 same DOS

    AAPC: Back to School
    Hello: We have received a claim (ASC) each month since June billing for 50590 x 3.

    2 separate Op Reports were provided for the same dos.

    1st Op report shows procedure
    **Left extracorporeal shockwave lithotripsy of left ureteral stone
    **Left extracorporeal shockwave lithotripsy of left renal stone

    2nd Op report shows procedure
    **Right extracorporeal shockwave lithotripsy of left ureteral stone

    Per my call with the MD each procedure was done in different anatomical areas so each code can be billed separately.

    Can anyone tell me if this is a correct statement? Thank you inadvance...

  2. #2
    Join Date
    Apr 2007
    Jacksonville Florida Chapter


    The doctor is correct.

    50590 is for extracorporeal shockwave lithotripsy, but it is not specific to an anatomical area. The rule is, if the code is not for a specific anatomical area and more than one area is worked on, then you can code for each individual area separately so long as it's documented in the medical record and it is by the op reports.

    The renal area is in the kidneys. The ureters are located between the kidneys and the bladder. Since the left and right ureters are worked on, then they can be coded separately.
    John Meyer, CPC-A
    Heekin Orthopedic Specialists

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