AHA Coding Clinic® for HCPCS - 2016 Issue 3; ASK THE EDITOR

Multiple lithotripsies

A patient with a left ureteropelvic junction (UPJ) and bilateral renal calculi was scheduled to undergo multiple lithotripsies at our facility. A bilateral lithotripsy with stent placement was performed utilizing a Holmium laser on the right and left kidney. Additionally, bilateral retrograde pyeloureterograms, and a right extracorporeal shockwave lithotripsy of the right inferior kidney was also performed. Per coding guidance it would be inappropriate to report the removal of multiple kidney stones from the same side. The National Correct Coding Initiative (NCCI) states: “the unit of service (UOS) for a procedure describing destruction or removal of renal system calculus(i) is one (1). The UOS is not each calculus. If a procedure for destruction or removal of renal system calculi is performed bilaterally, the CPT code may be reported with modifier 50 and one (1) UOS.” What are the correct code assignments for the multiple lithotripsies performed in this case? ...

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