How To Use CPT Code 52277

CPT 52277 describes a specific surgical procedure known as cystourethroscopy with resection of the external sphincter, also known as sphincterotomy. This article will provide an overview of CPT code 52277, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 52277?

CPT 52277 is a code used to describe a surgical procedure called cystourethroscopy with resection of the external sphincter, or sphincterotomy. 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 incises the muscular valve of the external sphincter to treat bladder outlet obstruction.

2. Official Description

The official description of CPT code 52277 is: ‘Cystourethroscopy, with resection of external sphincter (sphincterotomy).’ This code represents the surgical excision of the external sphincter to alleviate bladder outlet obstruction.

3. Procedure

1. With the patient prepped and under appropriate anesthesia, the provider inserts a cystoscope into the urethra and slowly advances it into the bladder.
2. Using a camera attached to the cystoscope, the provider visualizes the bladder and urethra on a monitor.
3. At the base of the bladder, where it connects to the urethra, there is a circle of muscles known as the external sphincter. The provider inserts a specialized cutting device through the cystoscope and incises these muscles to allow urine to flow more freely through the sphincter.
4. An electrocautery device may be used to stop any bleeding that occurs during the procedure.
5. The provider then injects sterile saline water into the bladder to irrigate it and improve the view of the bladder wall.
6. After thoroughly examining the bladder and urethra, the provider withdraws the instruments and scope.
7. A temporary catheter may be inserted to allow the external sphincter to heal.

4. Qualifying circumstances

CPT 52277 is typically performed on patients who have bladder outlet obstruction. This procedure may be necessary for conditions such as urinary retention, urethral strictures, or other obstructions that impede the flow of urine from the bladder. The provider must assess the patient’s condition and determine the need for cystourethroscopy with sphincterotomy.

5. When to use CPT code 52277

CPT code 52277 should be used when a provider performs cystourethroscopy with resection of the external sphincter to treat bladder outlet obstruction. It is important to note that this code should only be used for the specific procedure described and not for other cystourethroscopy procedures or sphincterotomy procedures.

6. Documentation requirements

To support a claim for CPT 52277, the provider must document the following information:

• Patient’s diagnosis indicating the presence of bladder outlet obstruction
• Description of the procedure performed, including the use of cystourethroscopy and resection of the external sphincter
• Date of the procedure
• Details of the surgical technique used
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 52277, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately document the procedure and provide the necessary supporting documentation. Additionally, be aware of any specific billing guidelines or requirements set forth by the payer or insurance company.

8. Historical information

CPT code 52277 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 patient with urinary retention undergoes cystourethroscopy with resection of the external sphincter to alleviate bladder outlet obstruction.
2. A provider performs cystourethroscopy with sphincterotomy on a patient with urethral strictures to improve urine flow.
3. A patient with recurrent urinary tract infections undergoes cystourethroscopy with resection of the external sphincter to address bladder outlet obstruction.
4. A provider performs cystourethroscopy with sphincterotomy on a patient with prostatic enlargement to relieve urinary symptoms.
5. A patient with a history of bladder stones undergoes cystourethroscopy with resection of the external sphincter to address bladder outlet obstruction.
6. A provider performs cystourethroscopy with sphincterotomy on a patient with a urethral stricture to improve urine flow.
7. A patient with neurogenic bladder undergoes cystourethroscopy with resection of the external sphincter to alleviate bladder outlet obstruction.
8. A provider performs cystourethroscopy with sphincterotomy on a patient with a urethral diverticulum to address bladder outlet obstruction.
9. A patient with recurrent urinary incontinence undergoes cystourethroscopy with resection of the external sphincter to improve bladder control.
10. A provider performs cystourethroscopy with sphincterotomy on a patient with a history of pelvic trauma to relieve bladder outlet obstruction.