Friday, November 2, 2007

Laser Treatment of Vesicle Neck Contracture

You Be the Coder
Which code should I use for holmium laser of a vesicle neck contracture?

Your coding for treatment of a bladder neck contracture (596.0) by holmium laser depends on the etiology of the bladder neck contracture.

Option 1: If the bladder neck contracture is secondary to benign prostatic hypertrophy present
predominately at the bladder neck, as often seen in younger men with obstructive symptoms, you should report 52450 (Transurethral incision of prostate).
Code 52450 represents an incision of the prostatic urethra, usually extending from and including the bladder neck to the verumontanum, the complete prostatic urethra.

Option 2: If the bladder neck contracture is secondary to a previous prostate surgery, such as an overzealous transurethral resection of the prostate [TURP] at the bladder neck, you'll instead use 52640 (Transurethral resection; of postoperative bladder neck

Option 3: If the bladder neck contracture occurs after a radical prostatectomy, which is in fact a urethral stricture at the vesicourethral junction, you should report 52276 (Cystourethroscopy with direct vision internal urethrotomy).

Note: You should use the above codes for any type of therapy and technology used for treating the bladder neck contracture, whether a laser, hot knife, cold knife or a single resection groove.

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