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Fistulogram

Nicole Posted Fri 08th of February, 2019 09:11:16 AM
Billing for an ASC... The provider performed a cystoscopy, bladder biopsy with fulgeration and fistulogram. Is the fistulogram billable separately from the bladder biopsy? If so, what would the CPT code be for this? (CPT: 20501?)
SuperCoder Answered Mon 11th of February, 2019 08:36:17 AM

Hi,

Thanks for your question.

Report 20501 (Injection of sinus tract diagnostic [sonogram]) since your urologist also performed the fistulogram. If your urologist documented that he interpreted the fistulogram, you should also report 76080 (Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation) for that service. Append modifier 26 (Professional component) to represent the urologist only interpreting and reporting the results.

Hope this helps.

Thanks.

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