Home » Categories » CPT Surgery/APC Coding

Cystoscopy with Retrograde Pyelogram bilateral


Question

I have a question regarding the appropriate coding of these. I have been using the 52005-50 for these.

This message came up when I was trying to code it and now am wondering if I have been doing this incorrectly.

Medicare indicates that the bilateral adjustment is inappropriate for 52005 because either: (a) physiology or anatomy, or (b) the code description specifically states that it is a unilateral procedure and there is an existing code for the bilateral procedure. Any help will be appreciated

Answer

Per CPT Assistant, May 2001, Pg 5, there are cystoscopy codes where it would not be appropriate to append a "50" modifier however there are some procedure that can be performed unilaterally where it would be appropriate to indicate that a procedure is performed bilaterally because of the extra work involved.  This list includes 52005, 52007 and 52320-52355.  If both ureters are catheterized, then it would be appropriate to assign a "50" modifier to 52005.

Disclaimer: All articles intended for general consumption only and not as a recommendation for a specific situation. Readers should consult an official source (AHA, AMA, etc.) or a qualified attorney for specific legal guidance.
Attachments Attachments
There are no attachments for this article.
Related Articles RSS Feed
Tenolysis in the Wound Care Center
Viewed 2161 times since Tue, Nov 16, 2010
Aspiration of Peritonsillar Abscess
Viewed 5309 times since Tue, Jul 12, 2011
Lithotripsy for Multiple Stones
Viewed 2215 times since Tue, Nov 16, 2010
Digital Nerve Block
Viewed 8151 times since Thu, Oct 27, 2011
Dental Block
Viewed 6078 times since Fri, Sep 2, 2011
Hip Core Decompression
Viewed 4613 times since Sun, Nov 14, 2010
Coding Intrathecal Pain Pump
Viewed 5156 times since Fri, Jun 24, 2011
Modifier PT for Colonoscopies
Viewed 4054 times since Tue, Mar 8, 2011
Drainage Tube Removal
Viewed 5233 times since Mon, May 2, 2011
Modifier PT and Medicare
Viewed 3825 times since Mon, Sep 19, 2011
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506