tci Outpatient Facility Coding Alert - 2018 Issue 3

You Be the Coder: Decipher This ESWL Code

Question: In the ASC, the surgeon performed a diagnostic bilateral ureteroscopy, then a left ESWL. Fluoroscopic evaluation confirmed a stone in the left lower pole. After these studies, the urologist opted to perform an ESWL on the left side. Is the diagnostic ureteroscopy included in the charge for the ESWL or should I bill for the ureteroscopy withmodifier 59? South Carolina Subscriber Answer: If the ureteroscopy, an endoscopic procedure, was truly a diagnostic procedure and led to the decision to perform extracorporeal shock wave lithotripsy (ESWL), you can bill both procedures. First, report 50590 (Lithotripsy, extracorporeal shock wave) for...

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