Doctor did a Cystourethroscopy with transurethral resection of OLD bladder tumor SITE.
As I am not dealing with a tumor and therefore cannot bill by size what would be the appropriate CPT code?
Any help would be appreciated.
KAM
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Tag Archives: bladder
Complete retroperitoneal ultrasound w/ bladder scan
One of the urologist physicians that I work for wants to report CPT 76770 along with CPT 51798 (Measurement of post voiding residual urine). Per AUA, a complete retroperitoneal ultrasound (CPT 76770) can be reported if complete evaluation of the kidneys and urinary bladder has been done and with clinical history suggesting urinary track pathology. AUA has added that "when an abdominal ultrasound and pelvic ultrasound are performed to evaluate the kidneys and bladder, technically both a 76705 and a 76857 are performed to evaluate each of these organs. However, the American Medical Association has determined that CPT code 76770 should be billed if the clinical history suggest urinary tract pathology." Based on this information, CPT 76705 + 76857 = 76770 (for evaluation of kidneys and urinary bladder). In addition, AUA indicates that "if the urologist performs bladder US to view the anatomy, the architecture , or the morphology of the full bladder as well as to DETERMINE PVR AFTER VOIDING, use CPT code 76857." My questions, is our physician wrong to report CPT 51798 if based on the information from AUA, the PVR is included in the complete retroperitoneal study? Or in what cases CPT 51798 can be unbundled since the it has indicator 1 when CPT 76770 and 51798 are report together? Hope I am making sense. Thank you in advance for any response
Cystoscopy, transurethral resection of bladder tumor/resection of prostatic mass
Please advise if the following procedure should be reported with procedure code 52204 or something else.
Patient was brought to the operating suite, placed in the lithotomy position, prepped and draped in the usual sterile fashion. After adequate general anesthesia was obtained, Ancef was given preoperatively. The cystoscope was inserted per urethra after a time-out was performed. The urethra was normal. Prostatic lobes were seen and enlarged. There was a median lobe kind of pointing over a little bit to his right side. Bilateral ureteral orifices were normal. Bladder was normal, but there was a cystic lesion that was anterior, but if you followed it, it actually seemed to attach more laterally on the left prostatic lobe bladder neck area extending into the bladder. Went ahead and did some biopsies of it with just a cold cup and sent it off separately to Pathology and then used the loop to resect the area on the prostate without any difficulty. Ellik was used to remove the chips. Hemostasis was excellent. The chips were sent separately as a specimen too of that prostatic mass area on the left lobe. At the end of the procedure, there were no specimens. The bladder was clear. Went ahead and left some fluid in and removed the cystoscope. A Foley catheter was placed without any difficulty and was put to drainage.
Bladder Tumors
Am I right on this?
For Medicare coding 52224-52240 you bill the largest tumor. For commercial you can add up the measurements.
Bladder Tumor Measurements
Hello I am need some advice about bladder tumor measurements when the Doctor and pathology report differ. My physician wants to bill out for a 5cm tumor but the pathology report doesn’t even measure 1 cm. The physician stands by his measuring. I am trying to look for guidelines on this but coming up short. Long story short he wants to bill out a 52240 and I suggested a 52234. Who is correct? The Doctor or the pathology report?
Medical Symptom Checker For Bladder Infection
A bladder infection (a.k.a cystitis) can leave you feeling miserable, yet with the proper steps you can control the medical symptoms of a bladder infection with no long lasting complications. This report reveals the measures you should take when you suspect a bladder infection and some bladder infection home cures you can use to decrease the burning and discomfort associated with the infection.
Bladder Infection Home Remedies and Information
An irritation of the bladder ordinarily results in a burning feeling as well as a lot more recurrent and pressing urination.Other signs incorporate the feasible existence of blood in the urine, a low fever, and/or pain in the stomach area or low back. Bladder bacterial bladder infections are much more typical in females than men.
The infection can result due to bacteria that enter the urinary system from the exterior (i.e. following sexual intercourse, or after a bowel movement). Chance of infection can be reduced by correct hygiene, wearing cotton undergarments and various simple alternatives that will be outlined in a moment.
If the aforementioned signs and symptoms are observed an individual is advised seek advice from with their medical professional to determine the kind of infection and if there are any complicating problems present. The medical professional may conduct a physical exam which includes urinalysis or cystoscopy (the use of a scope to look within the bladder) to formulate a correct analysis.
Soon after attaining a correct analysis the doctor may prescribe anti-biotics and the subsequent home treatments may provide some reduction of signs and symptoms:
Warm baths may alleviate soreness
Females may find that pouring warm water over the genital region through urination may help relieve the pain
Consuming extra glasses of drinking water is strongly suggested and helps flush out micro organism in the bladder
Empty your bladder once the urge hits. Do not put off urination because this can permit micro organisms to multiply
Following a bowel movement, females should keep away from wiping from back to front
Stop smoking, in particular if you are susceptible to recurrent bladder bacterial infections. Smoking can irritate the lining of the urinary tract.
Dress in loose fitting clothing and wear 100 % cotton undergarments.
Take your health into your own hands and learn more about Bladder Infections
Did you ever wish you had a simple tool that could walk you through your symptoms and lead you to an online diagnosis? Get a good idea of what your symptoms mean by simply answering yes or no using this Medical Symptom Diagnosis Tool.
Related Medical Coding Articles
Bladder Flap Adhesion’s
I need some help with coding a procedure. I have coded 58660, but my coding is being questioned. I am being told I should have coded 49329 due to the adhesion’s being bladder flap adhesion’s, so I really need a 2nd opinion. Any help would be greatly appreciated!
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Op note:
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Op note:
Attention was then directed to the adhesion of the bladder flap to the anterior fundal region of the uterus. Using the electrocautery hook on the suctioning device and bipolar setting, this adhesion was sharply and bluntly dissected off of the anterior aspect of the uterus, easing much of the tension on the bladder flap region. Adequate hemostasis was noted.
No further pathology was noted and therefore all instruments were removed from the laparoscopic sleeves and the pnuemoperitoneum was allowed to escape into the atmosphere.
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Please let me know what you would code this procedure as.
Thank you 
Cystourethoroscopy w/dilation of bladder with bladder irrigation
I’m new to Urology coding and I have a procedure that was performed and 51700-51 is being denied as inclusive. It was coded with 52260. The op report reads:
The cystoscope was advanced per urethra into the bladder and panendoscopy was performed demonstrating absence of mucosal defects within the bladder, the bladder neck and the urethra. Ureteral orifices are in normal position. The bladder was stretched to maximum capacity under gravity drainage and remained stretched in this manner for a total of 8 minutes at which time the bladder was drained of all fluid. The terminal portion of the drainage was minimally grossly bloody. The volume measured was 500 mL. Cystoscopy was then repeated demonstrating a moderate amount of glomerulation throughout the bladder. The bladder was drained of all fluid and the cystoscope was removed. A 14-French red rubber catheter was advanced into the bladder and the DMSO solution containing also Kenalog, bicarb and heparin was instilled into the bladder, and once within, the catheter was removed leaving the fluid within the bladder.
I haven’t been able to find anything that these are inclusive. Any help on this would be appreciated.
Bladder Tumor Resection and Ureteral Stent placement
Can someone please offer guidance?
My provider performed transurethral resection of bladder tumor that invaded the ureteric orifice. He inserted a stent to "facilitate drainage".
NCCI Edits bundle the two procedures together, is it appropriate to unbundle them in this scenario?
My provider performed transurethral resection of bladder tumor that invaded the ureteric orifice. He inserted a stent to "facilitate drainage".
NCCI Edits bundle the two procedures together, is it appropriate to unbundle them in this scenario?
"The patient had a large, approximately 3-4 cm papillary bladder tumor on his right lateral wall, obscuring the identification of his right ureteral orifice. This was resected sequentially down to muscle. The right ureteral orifice was identified and it was not the source of the tumor, but did appear to have some involvement of papillary tumor at the orifice. The right ureteral orifice was resected and sent as a separate pathologic specimen. Given the resection, we placed a ureteral stent on this side to facilitate drainage and also assist future resections."
52332-59-RT
52335
Thanks in advance…
PST and bladder instillations
Hello there! I am in need of assistance on how to bill the below procedures…
Procedure #1: What CPT and HCPCS am I going to bill?
PST: Informed consent given. Pt. placed in dorsolithotomy position. After cleansing patient with iodine swabs, bladder was cathed using a straight cath. 40 cc of Solution A was instilled in the bladder. After two minutes, patient is asked to rate the discomfort and urgency on a scale of 0-4 with 4 being the worst they could imagine. Water is drawn off and 40 cc of Solution B was instilled into the bladder. After two minutes, patient is again asked to rate the discomfort and urgency on a scale of 0-4, considering their baseline.
Solution A: Normal Saline Solution
Ratings: Discomfort2 Urgency 0
B: Potassium solution: 20 cc KCL, 80 cc normal saline
Ratings: Discomfort4 Urgency 4
Treatment Rescue Solution: 4 cc Heparin, 10,000 units/cc, 5 cc lidocaine 1%, 10 cc sodium bicarb, 5 cc Marcaine.
Rescue Solution was instilled in the bladder and pt. was instructed to retain fluid for at least 1/2 hour, but up to 2 hours before urinating.
Procedure #2: What CPT and/or HCPCS am I going to bill?
Pt placed in dorsolitotomy position. After cleansing with betadine swabs x 3, pt. was catherized with a straight cath. Treatment Rescue solution: 4 cc Heparin, 10,000 units/cc, 5 cc lidocaine 1%, 10 cc sodium bicarb, 5 cc Marcaine was instilled into the bladder. Pt. instructed to leave solution in bladder for 1/2 hour to 2 hours before urinating. Pt. tolerated procedure well.