How To Use CPT Code 52214

CPT 52214 describes a specific procedure used in urology. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 52214?

CPT 52214 is a code used to describe a cystourethroscopy procedure that involves the destruction (fulguration) of tissue in various areas of the urinary system using different methods such as electrocautery, cryosurgery, or laser surgery. This procedure is typically performed by a urologist to treat conditions affecting the bladder trigone, bladder neck, prostatic fossa, urethra, or periurethral glands.

2. Official Description

The official description of CPT code 52214 is: ‘Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands.’

3. Procedure

1. During a cystourethroscopy procedure, the urologist inserts a cystoscope through the urethra and into the bladder to visualize the structures of the urinary system.
2. The provider examines the bladder trigone, bladder neck, prostatic fossa, urethra, and periurethral glands using the camera attached to the cystoscope.
3. If any suspicious tissue or abnormalities are identified, the urologist may choose to destroy them using different methods such as electrocautery (high-frequency electric current), cryosurgery (intense cold), or laser surgery (intense heat).
4. The procedure may involve the use of specialized instruments inserted through the cystoscope to perform the fulguration.
5. Once the fulguration is completed, the urologist removes the instruments and drains the bladder if necessary.

4. Qualifying circumstances

CPT 52214 is typically performed on patients who have conditions affecting the bladder trigone, bladder neck, prostatic fossa, urethra, or periurethral glands. These conditions may include bladder tumors, urethral strictures, or other abnormalities that require treatment through tissue destruction. The procedure is performed by a urologist who has the necessary expertise and qualifications to perform cystourethroscopy and fulguration.

5. When to use CPT code 52214

CPT code 52214 should be used when a urologist performs a cystourethroscopy procedure with fulguration of tissue in the specified areas of the urinary system. This code is appropriate when the procedure involves the destruction of tissue using electrocautery, cryosurgery, or laser surgery. It is important to accurately document the specific areas targeted for fulguration during the procedure.

6. Documentation requirements

To support a claim for CPT 52214, the urologist must document the following information:

• Patient’s diagnosis and the need for cystourethroscopy with fulguration
• Specific areas targeted for fulguration (bladder trigone, bladder neck, prostatic fossa, urethra, or periurethral glands)
• Method used for fulguration (electrocautery, cryosurgery, or laser surgery)
• Date and duration of the procedure
• Any complications or additional procedures performed
• Signature of the urologist performing the procedure

7. Billing guidelines

When billing for CPT 52214, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately document the areas targeted for fulguration and the method used. Modifier 78 should be appended if the procedure is performed within the postoperative period of a related procedure. It is also important to follow any specific billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 52214 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A urologist performs cystourethroscopy with fulguration of a bladder tumor in a patient.
2. A patient with urethral stricture undergoes cystourethroscopy with fulguration to treat the condition.
3. A urologist performs cystourethroscopy with fulguration of periurethral glands in a patient with recurrent urinary tract infections.
4. A bladder cancer patient undergoes cystourethroscopy with fulguration of suspicious tissue in the bladder trigone.
5. A urologist performs cystourethroscopy with fulguration of prostatic fossa tissue in a patient with benign prostatic hyperplasia.
6. A patient with recurrent bladder stones undergoes cystourethroscopy with fulguration to remove the stones and treat the underlying condition.
7. A urologist performs cystourethroscopy with fulguration of urethral tissue in a patient with urethral diverticulum.
8. A patient with recurrent hematuria undergoes cystourethroscopy with fulguration to treat the bleeding source.
9. A urologist performs cystourethroscopy with fulguration of bladder neck tissue in a patient with bladder neck contracture.