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Urology Coding Alert

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Cysto and Chemical Fulguration with SP Tube Change

Question: My urologist performed a cystoscopic examination because of gross hematuria via an established suprapubic tract and silver nitrate chemical fulguration of several bleeding granulations on the mucosa of the ostomy. He also changed the SP tube. How would I report this procedure?Ohio SubscriberAnswer: First, report 52000 (Cystourethroscopy [separate procedure]) for the cystoscopic examination via the suprapubic tract. Then, use 51705 (Change of cystostomy tube; simple) for the change of the suprapubic (SP) tube. Finally, report 17250 (Chemical cauterization of granulation tissue [proud flesh, sinus or fistula]) for the fulguration of the bleeding mucosal granulations of the ostomy.Use 599.71 (Gross hematuria) or the findings such as bladder tumor, stone, or inflammation to show the medical necessity of the cystoscopic examination. Use whatever the original diagnosis for the cystostomy was -- such as 788.20 (Urinary retention) -- for the suprapubic catheter change.Also append V55.5 (Attention to artificial openings, ... removal or replacement of [...]

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