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Urology/ Turp?

Cherie Posted Wed 27th of August, 2014 10:57:00 AM

I have a question, my Dr. did a turbt and a "turp" at an outside ASC. His verbiage is " using the resectoscope with a 30 degree lens, I proceeded to resect the bladder tumor in it's entirety without any problems. There was no evidence of any perforations. I used the Ellik evacuator to remove all the fragments. Upon completion the median lobe was oozing and I attempted to cauterize the median lobe without success. As I put the cath in, it was bleeding; therefore, I went ahead and replaced the resectoscope and proceeded to resect the median lobe and some of the lateral lobes towards the bladder neck in order for him to continue to urinate. " He then did a complete Turp at the hospital later in the day. Please advise. Thank you

SuperCoder Answered Thu 28th of August, 2014 11:46:34 AM

Your query is bit unclear. Can you please specify which area you need advise upon, it would help us answer you in a better way.

Cherie Posted Thu 04th of September, 2014 08:18:06 AM

He did one surgery early in the day at an ASC , then did a second surgery later at a hospital. He says he did a Turp the first time, please see above note for the verbiage. He "resected the median lobe and some of the lateral lobes towards the bladder neck in order for him to continue to urinate. He also said he did a Turp at the second surgery also. Do you think that the first surgery verbiage constitutes a "Turp" and how do I bill for two surgeries in one day or can I bill for two surgeries in one day. Thanks

SuperCoder Answered Sun 07th of September, 2014 08:30:49 AM

Thank you for providing additional information.

CPT code 52234 to be coded for bladder tumor resection; size of tumor is not mentioned so we can code it to least. Supporting documentation is "using the resectoscope with a 30 degree lens, I proceeded to resect the bladder tumor in it's entirety without any problems. There was no evidence of any perforations. I used the Ellik evacuator to remove all the fragment"
'
For coding earlier surgery at ASC, surgeon performed a TURP which should be coded with CPT 52601. Supporting documentation is 'the median lobe was oozing and I attempted to cauterize the median lobe without success. As I put the cath in, it was bleeding; therefore, I went ahead and replaced the resectoscope and proceeded to resect the median lobe and some of the lateral lobes towards the bladder neck in order for him to continue to urinate'

For Second TURP surgery at the hospital.

You need to first confirm with the surgeon if it was a staged surgery or not and issue codes accordingly:

a. If second surgery was a staged procedure- For second stage partial resection of prostate, use 52601 with modifier 58.

b. If second surgery was not a staged surgery- Since TURP (CPT 52601) has a 90-day global period, residual prostate tissue resection with be coded with CPT 52630 with modifier 78.

Hope if answers your query. Let us know if you need any further assistance on this query.

Thank you!

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