Resolved Lithotripsy Coding Dilemma.

[ToniM_13794]

Am coding a sample case for a Bilateral Lithotripsy for a PT with Nephrolithiasis, using Flouroscopic guidance. Looking at code 50590 & am puzzled. Question: Is it appropriate to use an addl code for the guidance? There is no parenthetical note at the code. If so, what Path & Lab code should I use for this type of guidance? Also, am assuming I can use Modifier 50 to address laterality. Would appreciate any advice.

 

[Lori]

No, you cannot report 76998 (Ultrasonic guidance, intraoperative) or any other radiology guidance code with 50590 as Ultrasound Guidance Is Not Separate from Lithotripsy.

There is usually a code also note for things to be coded separately in CPT.

Cystourethroscopy and transurethral procedures include fluoroscopy when performed.

23. Fluoroscopy (CPT code 76000) is an integral component of all endoscopic procedures when performed. CPT code 76000 shall not be reported separately with an endoscopic procedure. (CPT code 76001 was deleted January 1, 2019.)

24. Cystourethroscopy and transurethral procedures include fluoroscopy when performed. CPT codes describing fluoroscopy or fluoroscopic guidance (e.g., 76000, 77002) shall not be reported separately with a cystourethroscopy or transurethral procedure CPT code. (CPT code 76001 was deleted January 1, 2019.)

https://www.cms.gov/files/document/chapter7cptcodes50000-59999final11.pdf

https://www.aapc.com/codes/coding-newsletters/my-urology-coding-alert/procedure-focus-get-answers-to-your-top-lithotripsy-questions-156053-article

https://www.supercoder.com/coding-n...-not-separate-from-lithotripsy-163185-article