Can CPT code 52005 be billed bilaterally?

CPT Code 52005 has a zero in the bilateral field (payment adjustment for bilateral procedure does not apply) because the basic procedure is an examination of the bladder and urethra (cystourethroscopy), which are not paired organs.

Can 52204 and 52005 be billed together?

Yes, if the ASC owned the equipment, you would bill with modifier -TC …and there should be an image available somewhere in the chart..

What does unilateral procedure mean?

What does 0 mean? If the code has an indicator of zero it is a unilateral code. Which means it will be paid per eye or site. In general, you can expect difficulties in getting paid if it is done the wrong way. If the code is assigned an indicator of 0, the procedure should in general not be performed bilaterally.

Can 52332 and 52005 be billed together?

52332 includes 52005. Can be unbundled for example if done on different sides.

Does CPT code of 52005 need a modifier on it?

CPT 52005 should not be billed with LT or RT modifiers as there are no paired organs for this CPT. You should also be able to bill the professional component of the retrograde with CPT 74420-26.

Can you have a stent put in your kidney?

To perform nephrostomy, a radiologist inserts a stent (tube) directly into a kidney. The kidney stent drains urine from the kidney into a bag outside of the body, bypassing the ureters and bladder. Ureteral stenting is an effective way to allow painful kidney stones to pass through the ureters and out of the body.

Can 51700 and 52000 be billed together?

The operative note indicates that the diagnostic and therapeutic portions of the procedure were separate. Therefore, we would recommend coding both the 52000 and the 51700-59 for this portion of the procedure.

How do you bill a cystoscopy?

You would use CPT code 52000 cystourethroscopy.

How does modifier 50 affect reimbursement?

Modifier 50 affects payment For Medicare and many commercial payors, proper application of modifier 50 increases reimbursement to 150 percent of the allowable fee schedule payment for the code to which the modifier is appended.

Can CPT code 52005 be billed with modifier 50?

Per Optum Coding Companion 2015 Urology/Nephrology -50 cannot be used on 52005; when our physicians perform bilaterally we bill 52005 with 2 units which is allowed; in some cases it is paid and other times it is not.

How do you bill for bilateral ureteroscopy?

Code 52356 (cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent [eg, Gibbons or double-J type]) includes the performance of lithotripsy and the insertion of the indwelling stent on the same side.

Is it appropriate to Bill code 52005 twice?

Neither is any additional payment made when both ureters are examined and code 52005 is billed with multiple surgery modifier “-51.” It is inappropriate to bill code 52005 twice, once by itself and once with modifier “-51,” when both ureters are examined.

What is the CPT code for urinary catheterization 52005?

Code 52005 has a zero in the bilateral field (payment adjustment for bilateral procedure does not apply) because the basic procedure is an examination of the bladder and urethra (cystourethroscopy), which are not paired organs. The work RVUs assigned take into account that it may be necessary to examine and catheterize one or both ureters.

What modifiers are not allowed with CPT 52005?

Per AAPC’s Procedural Coding Expert 2017, modifiers RT, LT and 50 are not allowed with CPT 52005. While this may seem counter-intuitive, the procedure is technically categorized as a bladder procedure, not a procedure on the ureters.

Can I use per Optum coding Companion 2015 Urology/Nephrology-50 on 52005?

Per Optum Coding Companion 2015 Urology/Nephrology -50 cannot be used on 52005; when our physicians perform bilaterally we bill 52005 with 2 units which is allowed; in some cases it is paid and other times it is not.