Tag Archives | Catheterization

Putting a Halt to ICD-10 AMI Documentation Obstacles

ICD-10 went into effect Oct. 1, 2015 and, so far, everything seems to be going pretty well. There are a few areas, however, that continue to give clinical documentation improvement (CDI) specialists and coders headaches. One of these problems is Acute Myocardial Infarction (AMI) documentation. In ICD-10 there is a demand for increased specificity – […]

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How Should You Report Cannulation of Colovesical Fistula?

Question: I’m unsure how to code for cannulation of colovesical fistula. The doctor also did a cystoscopy with bilateral retrogrades and bladder biopsies. How should I report this procedure?
Answer: There is no specific CPT code for cannulation of th…

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In 2013, Reporting Ureteral Stone Diagnoses Will Include More Options

Here is what you should check in your physician’s documentation.
As the conversion takes place from ICD-9 to ICD-10 in 2013, you will not be treating the codes in a way you always did. Often, you will have more options that may need tweaking the way …

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Calculi Coding: Capture Full Pay for Multiple Fragmentations

When your urologist fragments more than one stone located in two different locations within the urinary tract during one operative session, the proper coding might leave you scratching your head: Can you ever report both procedures? If you can, how do you sequence the codes? Tackle these tough questions by reviewing a sample scenario.

Your urologist performs a ureteroscopic laser lithotripsy of a left ureteral stone and lithotripsy of a bladder stone. How should you code these procedure performed during one operative session?

Separately Report Procedures Based on Anatomy

Depending on where the stones are in the urinary tract, you may be able to separately report and be paid for multiple fragmentation procedures during the same session. For a ureteroscopic fragmentation of a ureteral or renal pelvic stone your urologist performs, you’ll report 52353 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy [ureteral catheterization is included]). Remember that 52353 applies to “any type of fragmentation, whether you use a Holmium laser, a Candela laser, a mechanical lithotripsy, or an ultrasonic lithotripter,” says Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology at the State University of New York at Stony Brook. If your urologist also fragments a bladder calculus during the same session, your coding will then depend on the different and separate anatomical location of the stones. Therefore, in the sample scenario, you can separately report those procedures. “We are dealing with two separate portions or parts of the urinary tract – a ureteral stone and a bladder stone,” Ferragamo explains.

According to the Correct Coding Initiative (CCI), codes 52317 (Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small [less than 2.5 cm]) and 52318 (…complicated or large [over 2.5 cm]) are bundled with 52353. Because both bundles have a…

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