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
CPT code 20610 vs. G0260 vs 27096
Viewed 5434 times since Tue, Apr 26, 2011
Holter Monitor / EKG Modifier 59
Viewed 1705 times since Fri, Oct 28, 2011
Bariatric Procedures
Viewed 1420 times since Wed, Apr 6, 2011
Replacement of Pacemaker Generator
Viewed 11748 times since Thu, Mar 15, 2012
Gastrostomy Tube Replacement
Viewed 24279 times since Thu, Jan 27, 2011
Dental Blocks
Viewed 10975 times since Tue, Feb 8, 2011
Surveillance Colonoscopy
Viewed 4661 times since Mon, Aug 1, 2011
Platelet Rich Plasma Injection with Total Knees
Viewed 1708 times since Thu, May 12, 2011
Modifier PT & 33
Viewed 3658 times since Thu, May 12, 2011
Loop Colostomy
Viewed 14275 times since Wed, Mar 9, 2011
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506