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Urology/Turbt/Bladder Biopsy

Cherie Posted Thu 05th of February, 2015 12:05:22 PM

Hi,
My question is, when is it appropriate to bill 52235 and 52204 with a modifier and to be sure it's justified.
Thanks

SuperCoder Answered Fri 06th of February, 2015 02:41:24 AM

You may bill both codes 52235 and 52204 together by appending modifier 59, distinct procedural service to code 52204. You will get reimbursement for both the codes when the provider performs biopsy of tissue other than one which is being fulgurated. If biopsy is performed for same tissue that the provider is doing fulguration for, biopsy code 52204 will be considered as included in code 52235.

Thanks !!

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