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Prostate bleeding

Denise Posted Thu 21st of January, 2016 11:41:26 AM

While resecting a a bladder tumor adjacent to a bladder diverticulum, dr stated "torquing of the scope caused bleeding on the anterior prostate and this was cauterized with resectoscop and Bugbee cautery with good hemostasis". He also noted earlier in the operative report "prostatic urethra revealed some BPH with lateral obstruction. In the ICD-10 code book under N42.1 congestion/HEMORRHAGE of prostate there is an EXCLUDES NOTE 1 - enlarged prostate (N40._). 1. Should I include 52214-59 for the fulguration? 2. If so, what Dx code to show for the fulguration?

As we are a urology practice, we often have to use cysto/irrigation of clots and/or fulguration for bleeding of the prostate. Some patients have BPH, some do not. ICD-10 confuses me on how to code a diagnosis for this. Any help would be appreciated.

SuperCoder Answered Fri 22nd of January, 2016 08:23:03 AM

Thank you for your question.

You may include the code for fulguration and while doing so, you can give the primary diagnosis for bladder tumor, the exact code for this varies on the detailed documentation, such as the exact location of the bladder tumor (For a malignant tumor, you may use a code in the code range C67.0-C67.9. The fourth digit identifies the specific location of the cancer). If you need to know the exact diagnosis code, then please provide me with more details on same.
Thanks!!

Denise Posted Tue 02nd of August, 2016 11:23:33 AM
What ICD 10 code is to be used for prostate bleeding when it has an Excludes 1 note "enlarged prostate N40._"? During a laser litholapaxy for a huge, dense bladder stone, the doctor had to do a TURP of the large, friable vascular median lobe of the prostate because of fairly profuse bleeding of the median lobe (median lobe was protruding into and obstructing the bladder outlet). Do I use N40.1 for the TURP and not worry about showing the prostate bleeding?
SuperCoder Answered Wed 03rd of August, 2016 05:16:27 AM
Yes I think code N40.1 is the correct code in this case.

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