1. Sheila Hurtubise
   Posted 3 months ago #
   

   I am trying to code "removal of Prostatic Stone by use of Holmium laser"

2. SuperCoder
   Posted 3 months ago #
   

   CPT 52648 is applicable in which Laser vaporization of prostate is performed.
   *
   It also includes control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed.
   *
   Many additional info can be found in:
   http://www.bostonscientific.com/templatedata/imports/collateral/Urology/broc_lumenis_01_ur_us.pdf

3. SuperCoder
   Posted 3 months ago #
   

   Hi Sheila.
   *
   52648 is not the proper coding in this case. As the code descriptor indicates, 52648 is for laser vaporization of the prostate itself (not a stone within the prostate as in your case). Code 52648 describes, in laymans terms, when the physician uses a laser to coagulate, vaporize, or enucleate the prostate through an endoscope or resectoscope inserted through the urethra and the entire prostate is treated. This procedure is peformed for patients with BPH with urinary obstruction (ICD-9 600.01) and related conditions.
   *
   Therefore, 52648 does not describe the procedure that your urologist performed “removal of prostatic stone by use of holmium laser", unless the stone was lasered and removed during the performance of laser vaporization of the total prostate, for which the lasering and removal of the stone would then not be separately billable.
   *
   There is no CPT code that accurately describes the laser removal of a prostatic stone.
   *
   I consulted with a colleague who is both a urologist and a urology coding expert (Jonathan Rubenstein, MD, director of coding and physician compliance for Chesapeake Urology Associates) and he had this advice:
   *
   "A more appropriate CPT code would be either 52310 (Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder [separate procedure]; simple); 52317 (Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small [less than 2.5 cm]); or an unlisted code such as 53899 (Unlisted procedure, urinary system).
   *
   Of course, using unlisted codes would require writing a letter and linking the procedure performed to a CPT code with with similar time, costs, and effort involved (in this case, 52317 would be an appropriate code to benchmark). Therefore, billing CPT 52317 seems most appropriate, as it most closely describes the procedure performed and would potentially allow the reimbursement for the cost of the laser fiber used."
   *
   I hope this helps.
   *
   Best,
   Leesa
   *
   Leesa A. Israel, BA, CPC, CUC, CMBS
   Executive Editor, The Coding Institute
   Manager, TCI Consulting & Revenue Cycle Solutions
   Email: leesai@codinginstitute.com
   http://www.codinginstitute.com

RSS feed for this Question