July 25, 2025
In this episode, Scott, Mark, and Ray answer coding questions submitted through the PRS Help Desk.
1) Payor: Medicare
State: FL
Code/Codes: 52353-52 and 52332-59-51
Catagory: Kidney Stones
Question: If I have to abort a planned ureteroscopy and laser lithotripsy because the UO is too narrow to pass the ureteroscope so I place a stent. Can I bill the 52353-52 and 52332-59-51
2) Can you clarify what documentation is required to be able to code 51729? Is the length of the urethra required to be documented or is it just a possible element?
The AUA policy & Advocacy brief for Urodynamcis shows the example documentation of the UPP as, “ Urethreal Pressue Profile: The maximum urethral pressue profile was 45 cm of water with a functional urethral lenght of 2.75 cm. At 200cc, coughing was iniitated. There was no demonstrable leak of urine at 117 cm of water with abdominal straining.”
My provider is only documenting: Leak point pressure testing: volume tested: 150mL, Stress Induced DO: Absent Valsalva Leak Point Pressure: No Leak.
Is that enough to capture 51729?
Thank you for your assistance!
3) Can you tell me the best way to document and correctly bill for prostate biopsy using 55700/76942 and 76872? I am told we are no longer getting paid for those.
4) What is the best way to document and code for placement of fiduciary markers under US guidance?
Thanks in advance
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