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52204 and 52332 denied

Nancy Posted Tue 17th of May, 2016 10:56:55 AM
Physician coded as 52240, 52332-RT and 52354XS-RT, Code 52240 and 52332 were denied by Medicare. Should an XU modifier be appended to 52240 and XS to 52332? The patient was taken to the operating room today for cystoscopy, right ureteroscopy with biopsy of papillary distal ureteral mass and comprehensive pyeloscopy,stent placement, and transurethral resection of flat bladder tumor covering approximately 24 cm² at the right trigone. He was not able to urinate, and was therefore discharged overnight. Approximately 500 cc of urine was recovered on placement of Foley catheter, despite a 60 cc residual volume as demonstrated by the nurses in the CPAP. His pain was nicely alleviated with Foley catheter placement.
SuperCoder Answered Wed 18th of May, 2016 09:43:59 AM
HI, Bill CPT code 52240-XU, 52332-XU-RT and 52354-RT as per the CCI edit modifier XS is not applicable with cpt code 52354. and Modifier XU is applicable to both cpt 52240 as well as 52332. As modifier XS is applicable for different structures.

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