This Scenario Throws Light On Your Upj Obstruction Coding

By Author: unknownmem
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These days, Laparoscopic procedures are a regular feature in urology practices and the same can be said about pyeloplasty procedures. Do not let this new surgical technique throw off your coding and cost your practice money.


If you are to get the proper reimbursements it is very important to understand how to code the various clinical scenarios associated with a pyeloplasty repair.


Take a look at this common scenario in coding pyeloplasty procedures to ensure you are up to speed.


You Should Watch For Bundles Involving Laparoscopic Pyeloplasty


In a particular scenario, your urologist carries out a laparoscopic pyeloplasty for a UPJ obstruction. He also carries out a preoperative cystoscopic examination and retrograde pyelogram and places a double J stent. In this case you should first bill for the highest paying service, the laparoscopic pyeloplasty as your primary procedure code. The proper code here is 753.21.


After this, you should bill for the insertion of the JJ stent using 52332. Add modifier 51 if your payer requires that modifier ...
... for multiple procedures performed during the same session and assign ICD-9 codes 591 and V07.8. Reporting V07.8 is "using a combination of ICD-9 codes to explain the placement of the stent prophylactically to prevent hydronephrosis.


Snag: You shouldn't bill the cystoscopy or retrograde pyelogram if carried out using 74420. Add modifier 26 (PC) to indicate your doctor only carried out the professional side of that service -- the film interpretation -- and that he does not own the hospital-based equipment nor pays for the technician or contrast materials used. Once more, you should use diagnosis code 753.21.


For further details on this and for other specialty-specific articles to assist your urology coding, sign up for a good coding resource like Coding institute.