How To Use CPT Code 52005

CPT 52005 refers to a cystourethroscopy procedure with ureteral catheterization, which may include irrigation, instillation, or ureteropyelography, exclusive of radiologic service. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 52005.

1. What is CPT 52005?

CPT 52005 is a medical procedure code used to describe a cystourethroscopy with ureteral catheterization. This procedure involves the inspection of the interior areas of the bladder, urethra, and ureteric pelvis, and may include additional steps such as irrigation, instillation, or ureteropyelography. Radiologic services, if performed, should be reported separately.

2. 52005 CPT code description

The official description of CPT code 52005 is: “Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service.”

3. Procedure

The 52005 procedure involves the following steps:

1. The provider inserts a cystoscope through the patient’s urethra and into the bladder.
2. The interior of the bladder, urethra, and ureteric pelvis are examined.
3. A catheter may be inserted into the ureter.
4. Optional steps may include irrigation of the bladder, instillation of fluids, or ureteropyelography to visualize or study ureteric and renal pelvic structures.
5. Radiologic services, if performed, are reported separately.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 52005 services are those experiencing symptoms or conditions that warrant a cystourethroscopy with ureteral catheterization. These may include urinary tract infections, bladder or ureteral stones, ureteral strictures, or other conditions affecting the urinary system. The provider must determine if the procedure is medically necessary and appropriate for the patient’s specific situation.

5. When to use CPT code 52005

It is appropriate to bill the 52005 CPT code when a provider performs a cystourethroscopy with ureteral catheterization, with or without additional steps such as irrigation, instillation, or ureteropyelography. The code should be used for patients who require this procedure to diagnose or treat conditions affecting the urinary system, as determined by the provider.

6. Documentation requirements

To support a claim for CPT 52005, the following information should be documented:

• Patient’s medical history and presenting symptoms or conditions.
• Physical examination findings related to the urinary system.
• Indication for the cystourethroscopy with ureteral catheterization procedure.
• Details of the procedure performed, including any additional steps such as irrigation, instillation, or ureteropyelography.
• Findings and observations during the procedure.
• Any complications or adverse events encountered during the procedure.
• Post-procedure care instructions and follow-up plan.

7. Billing guidelines

When billing for CPT code 52005, keep in mind the following guidelines:

• Do not report CPT code 52000 along with CPT code 52005, as the latter includes the former.
• If a retrograde pyelogram is performed in a hospital setting with a radiology technician, bill CPT code 52005 and CPT codes 74420-26, with modifier 26 indicating the physician’s interpretation of the radiologic results.
• If a retrograde pyelogram is performed in a hospital setting with a radiologist present, the surgeon should bill CPT code 52005 only.
• If a retrograde pyelogram is performed in a physician’s office using physician-owned equipment and a technician, bill CPT code 52005 and CPT code 74420 with no modifiers.

8. Historical information

CPT 52005 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2010, with the previous descriptor being “Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service.”

9. Similar codes to CPT 52005

Five similar codes to CPT 52005 and how they differ are:

• CPT 52000: This code describes a basic cystourethroscopy without ureteral catheterization.
• CPT 52001: This code involves a cystourethroscopy with urethral dilation.
• CPT 52004: This code describes a cystourethroscopy with the removal of a foreign body or calculus.
• CPT 52007: This code involves a cystourethroscopy with the treatment of a ureteral stricture.
• CPT 52010: This code describes a cystourethroscopy with the removal of a ureteral stent.

10. Examples

Here are 10 detailed examples of CPT code 52005 procedures:

1. A patient with recurrent urinary tract infections undergoes a cystourethroscopy with ureteral catheterization to evaluate the urinary system for any abnormalities.
2. A patient with a history of bladder stones undergoes a cystourethroscopy with ureteral catheterization and irrigation to remove any remaining stone fragments.
3. A patient with suspected ureteral stricture undergoes a cystourethroscopy with ureteral catheterization and instillation of contrast medium for ureteropyelography.
4. A patient with hematuria undergoes a cystourethroscopy with ureteral catheterization to evaluate the source of bleeding.
5. A patient with a history of ureteral stent placement undergoes a cystourethroscopy with ureteral catheterization to assess stent position and function.
6. A patient with a suspected ureteral stone undergoes a cystourethroscopy with ureteral catheterization and ureteropyelography to confirm the presence and location of the stone.
7. A patient with a history of bladder cancer undergoes a cystourethroscopy with ureteral catheterization to monitor for recurrence or progression of the disease.
8. A patient with lower urinary tract symptoms undergoes a cystourethroscopy with ureteral catheterization to evaluate the bladder and urethra for any abnormalities.
9. A patient with a history of pelvic radiation therapy undergoes a cystourethroscopy with ureteral catheterization to assess for radiation-induced damage to the urinary system.
10. A patient with a suspected ureteral injury following a recent surgical procedure undergoes a cystourethroscopy with ureteral catheterization to evaluate the integrity of the ureter.