Urology is a surgical specialty that addresses urinary tract and reproductive system problems in men and women. Urinary tract infections and enlarged prostates are treated medically, while bladder cancer, prostate cancer, kidney stones, and stress incontinence are treated surgically.
Like other medical specialties, it involves outpatient surgeries, inpatient and urgent care, diagnostic testing, and therapies. Therefore, a thorough understanding of the right urological CPT codes will ensure precise billing and reimbursement.
Continue reading to learn about some of the most widely used CPT codes in urology and their associated procedures.
52000 – Procedure separate: diagnostic cystoscopy
A cystourethroscopy, a thin, flexible, or stiff tube with a camera on one end, is used in this technique by the doctor to examine the interior of the bladder, urethra, and ureteric apertures.
52001 – Cystourethroscopy, ureteral catheterization, irrigation, instillation, or ureteropyelography without radiologic service
A cystourethroscopy, a thin, flexible, or stiff tube with a camera on one end, is used in this technique by the doctor to examine the interior of the bladder, urethra, and ureteric apertures. The doctor will then use a suction and irrigation probe to remove several blocking clots.
52005 – Cystourethroscopy with a ureteral stent (such as a Gibbons or double-J type) implanted
The doctor conducts a cystourethroscopy, inspecting the bladder, urethra, and ureteric pelvis inside out; he may or may not irrigate the bladder, inject fluids, or undertake imaging of the ureter and renal pelvis. When performing radiologic services, separate reports should be made.
52007 – Simple (separate procedure); difficult (separate procedure) Cystourethroscopy with the removal of foreign body, calculus, or ureteral stent from urethra or bladder
The clinician uses a brush placed via the scope to biopsy the ureter and renal pelvis during a cystourethroscopy. The doctor may or may not perform ureter and renal pelvis imaging, bladder irrigation, or fluid injections.
52204 – (A separate method) Cystourethroscopy
A cystoscope inserted through the urethra and into the bladder allows the doctor to inspect the urethra, prostatic urethra (in men), bladder interior, and ureteric apertures. The cystoscope can also be used to obtain biopsies.
52317 – Litholapaxy: the removal of fragments after crushing or fragmenting calculus in the bladder using any method
By utilizing a cystoscope that is inserted via the urethra and into the bladder to examine the interior of the bladder, the urethra, the prostatic urethra, and the ureteric apertures, the doctor can locate, crush, and remove tiny stones that are less than 2.5 cm in diameter.
54056 – Under Penis Destruction Procedures
The physician uses liquid nitrogen on the skin lesion of the penis, such as a condyloma, papilloma, molluscum contagiosum, or herpetic vesicle, and the lesion is destroyed. The lesions were frozen and removed as a result. The doctor removes the lesion and alleviates pain; he performs the treatment.
57160 – Removal of a vaginal foreign body via surgery (different procedure)
The doctor performs this treatment to treat vaginal wall prolapse or other diseases by fitting and inserting a pessary or similar device into the vagina.
58100 – Polypectomy, whether straightforward or complex (separate procedure), endometrial biopsy, and biopsy of the corpus uteri lining
The medical professional collects tissue from the uterine lining to perform an endometrial biopsy without opening the cervix. The doctor may also do an endocervical biopsy.
58300 -The Corpus Uteri Introduction Procedures
In this process, the medical professional inserts an intrauterine device (IUD) for contraception inside the uterus.
51798 – bladder capacity and post-voiding residual urine measurements using ultrasound, without imaging
Medical professionals perform this ultrasonography test to gauge the bladder’s remaining urine capacity.
54150 – Under Penis Excision Procedures
Using a clamp or other tool and regional anesthetic made up of a dorsal penile or ring block, the doctor performs a circumcision, a surgical operation that removes the foreskin of the penis.
54200 – Circumcision and foreskin removal through surgery
The doctor injects medicine into the penis’ exterior. A doctor carries out this treatment to treat Peyronie disease, a condition marked by an abnormal curvature of the erect penis.
57288 – Under Vaginal Repair Techniques
To treat urinary stress incontinence, the doctor installs a sling beneath the urethra composed of fascia or synthetic material to support it in the proper posture. Depending on whether the doctor uses a pubocervical or transvaginal sling, the procedure can be carried out either vaginally or abdominally.
58558 – Surgery hysteroscopy combined with biopsy
Through a hysteroscope, the doctor either removes polyps or performs an endometrial biopsy (endometrial biopsy) or both. The doctor might or might not conduct a dilatation and curettage (D&C).
76705 – Abdominal ultrasound, full
The liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta can all be examined using abdominal ultrasound, a non-invasive treatment. This specific code is utilized when an ultrasound is constrained (to a single organ, quadrant, or used for follow-up) and real-time image documentation is necessary.
76857 – Pelvic (non-obstetric) ultrasound
A pelvic ultrasound is a non-invasive procedure to check one or more pelvic tissues, such as the bladder, prostate gland, and seminal cysts in males and the uterus, cervix, and fallopian tubes in women. Images are archived and displayed on a monitor.
74420 – Urinalysis, radiological oversight, and interpretation
Retrograde urography, often referred to as retrograde pyelography, is a procedure where a doctor uses a catheter to insert radiopaque contrast material against the usual flow of fluid into the kidney and ureters to obtain an image of the urinary tract. The doctor performs this operation to look into an upper urinary tract obstruction.
FAQs
Q1: How does urology medical billing work?
Medical billing for urology involves submitting and tracking down urological claims with health insurance companies to get payment for services rendered by a healthcare professional. The provider’s office staff or a separate billing business often handles medical billing.
Q2): How does urology medical coding work?
Medical coding for urology entails the conversion of urological diagnoses, treatments, services, and equipment into standard alphanumeric codes for use in the medical field. The documentation in the medical records serves as the basis for the diagnosis and procedure codes. The same goes for transcriptions of medical documents, labs, radiologic test findings, etc.
Conclusion
Numerous CPT codes may be used during urology operations, which range from diagnostic to surgical. New urology CPT codes may be available as the medical field develops and technology improves. As a result, it’s critical to keep up with the most recent coding updates and ensure that all claims appropriately reflect the services rendered. Consultation with a urologist or a medical coder can help assure proper compliance and maximize reimbursement for urological procedures.