How To Use CPT Code 52240

CPT 52240 describes the procedure of cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of large bladder tumors. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 52240?

CPT 52240 can be used to describe a specific surgical procedure known as cystourethroscopy. This procedure involves the use of a cystoscope, a lighted tubular instrument, to inspect the urethra, prostatic urethra (in men), the interior of the bladder, and ureteric openings. During the procedure, the provider may perform fulguration (using high-intensity electric current), cryosurgery (using intense cold), or laser surgery (using intense heat) to destroy or remove large bladder tumors.

2. Official Description

The official description of CPT code 52240 is: ‘Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s)’

3. Procedure

1. The patient is appropriately prepped and anesthetized, which may involve instilling anesthetizing gel into the urethra and/or sedating the patient.
2. The provider inserts a cystoscope into the urethra and slowly advances it into the bladder, using a camera attached to the cystoscope to view the bladder on a monitor.
3. The provider examines the urethra, prostatic urethra (in men), and the lining of the bladder, injecting sterile saline water into the bladder to improve visibility.
4. If there are large bladder tumors present, the provider may use fulguration, cryosurgery, or laser surgery to destroy or remove them.
5. Upon completion of the procedure, the provider removes the instruments and drains the bladder.

4. Qualifying circumstances

CPT 52240 is used for patients with large bladder tumors that require cystourethroscopy with fulguration, cryosurgery, or laser surgery. The procedure is typically performed by a urologist or other qualified healthcare professional. The patient must meet the criteria for the procedure, such as having a confirmed diagnosis of large bladder tumors and the need for intervention to remove or destroy them.

5. When to use CPT code 52240

CPT code 52240 should be used when a patient requires cystourethroscopy with fulguration, cryosurgery, or laser surgery to treat large bladder tumors. It is important to accurately document the size and location of the tumors to support the use of this code. If the procedure is performed for a different reason or involves different types of tumors, a different CPT code may be more appropriate.

6. Documentation requirements

To support a claim for CPT 52240, the healthcare professional must document the following information:

• Patient’s diagnosis of large bladder tumors
• Details of the procedure performed, including the use of fulguration, cryosurgery, or laser surgery
• Size and location of the tumors
• Any complications or additional procedures performed
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 52240, ensure that the procedure meets the criteria for cystourethroscopy with fulguration, cryosurgery, or laser surgery for large bladder tumors. It is important to accurately document the procedure and provide any necessary supporting documentation. Be aware of any specific payer guidelines or requirements for reporting this code. Additionally, consider any applicable modifiers that may be required for proper billing.

8. Historical information

CPT 52240 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 performing cystourethroscopy with fulguration to remove a large bladder tumor.
2. A healthcare professional using cryosurgery during cystourethroscopy to treat a large bladder tumor.
3. A patient undergoing cystourethroscopy with laser surgery to destroy a large bladder tumor.
4. A urologist performing cystourethroscopy with fulguration and resection to remove multiple large bladder tumors.
5. A healthcare professional using cryosurgery and laser surgery during cystourethroscopy to treat large bladder tumors in a single procedure.
6. A patient undergoing cystourethroscopy with fulguration and transurethral resection of bladder tumor(s) to remove large bladder tumors.
7. A urologist performing cystourethroscopy with fulguration and transurethral resection of prostate to treat large bladder tumors and address prostate issues.
8. A healthcare professional using cryosurgery and transurethral resection of bladder neck during cystourethroscopy to treat large bladder tumors and address bladder neck issues.
9. A patient undergoing cystourethroscopy with fulguration and transurethral resection of bladder tumor(s) to remove large bladder tumors and address specific tumor locations.