Surgery: Urinary System (June 2007)

June 2007 page 10d Coding Communication:Surgery: Urinary System Question A patient presents for a cystourethroscopy with ureteroscopy and removal of a calculus that is located in the ureter. In attempting the cystourethroscopy a urethral stricture is encountered that needs to be dilated in order to gain access to the calculus. Is it appropriate to report both of these endoscopies? AMA Comment Yes. There are times when one endoscopic procedure must be performed before a more extensive endoscopic procedure can be performed due to anatomical locations. In this case, the dilation of a stricture is not included in the primary...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article is a CPT Assistant coding communication focused on urinary system surgery. It discusses how a cystourethroscopy/ureteroscopy scenario with an additional urethral dilation is handled, and it highlights reporting considerations involving multiple endoscopic procedures and modifier use. It is intended for coders, billers, and revenue cycle staff working with urology procedures.

Why This Topic Matters

It helps coding professionals recognize when more than one endoscopic service is represented in a single operative session and how the article frames the reporting approach. The guidance is relevant to accurate claim submission, documentation review, and compliance in urology coding.

Article Sections

  1. Coding Communication: Surgery: Urinary System

    Introduces a coding question involving urinary system endoscopy and a related procedural circumstance.

  2. AMA Comment

    Provides the editorial response and a brief explanation of the reporting approach discussed in the communication.

  3. For example, the appropriate reporting is as follows

    Presents the example code reporting associated with the scenario discussed in the article.

What You Will Learn

  • The article’s focus within urinary system surgery coding
  • How a multi-procedure endoscopic scenario is discussed in a coding communication
  • The general role of modifier use in this type of reporting discussion
  • The type of example provided for urology endoscopy reporting

Who Should Read This

  • Medical coders
  • Urology billing staff
  • Revenue cycle professionals
  • Coding auditors
  • Compliance teams

Codes Discussed

Modifiers Discussed


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