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Resection then vaporization of the prostate

Karen Posted Tue 27th of August, 2019 16:08:07 PM
The physician selected 52648 for this procedure: "Using the bipolar prostate loop, I began resecting first the large ball-valving median lobe followed by the lateral lobes. Once a large portion of prostate tissue was removed and hemostasis was good, an Ellik evacuator was used to remove the prostate chips...Once the mass of the prostate was removed, the button vaporization probe was use to sculpt the nice prostatic urethral channel at the end." I'm thinking the CPT should be 52601 since most of the prostate was resected. Which is correct?
SuperCoder Answered Wed 28th of August, 2019 03:36:06 AM

Hi Karen,


Button TURP is also known as bipolar cautery vaporization of Prostate. Provider performed most of the procedure using bipolar cautery. Therefore, it would be appropriate to use CPT code 52648 for prostate resection performed with bipolar cautery and Laser.


Hope provided information would be helpful.



Karen Posted Wed 28th of August, 2019 08:37:08 AM
Previous articles about "button TURP" have said to use 52601. In this scenario, chips were removed--that implies RESECTION, which is 52601. Please explain--if it were vaporized, there would not be prostatic chips
Karen Posted Wed 28th of August, 2019 08:42:10 AM
Look at the question from April 16, 2010, which states that although it resembles 52648, 52601 should be used.
SuperCoder Answered Thu 29th of August, 2019 08:20:54 AM

This Karen,


Thank you for the follow up query.


Prostate surgery has undergone lot of changes in recent years. Different type of prostate surgeries are performed through different ways. In your case, bipolar prostate loop was used to resect the prostate and later button vaporization was used to sculpt the prostatic channel. Vaporization of prostate performed through button would be coded with CPT code 52601. Had the vaporization been performed through laser, CPT code 52648 would had been the code of choice.

The word vaporization can lead to confusion since vaporization is performed through laser as well as button. It is requested to verify the exact procedure details from the medical records to avoid any denials. 


Thank you!



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