How To Use CPT Code 52290

CPT 52290 describes a specific procedure known as cystourethroscopy with ureteral meatotomy, which involves the inspection of the urethra, prostatic urethra (in men), the interior of the bladder, and the incision of one or both openings of the ureters. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 52290?

CPT 52290 is a code used to describe the procedure of cystourethroscopy with ureteral meatotomy. This involves the use of a cystoscope, a lighted tubular instrument, to inspect the urethra, prostatic urethra (in men), the interior of the bladder, and the ureteric openings. During the procedure, the provider may also incise one or both openings of the ureters.

2. Official Description

The official description of CPT code 52290 is: ‘Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral.’

3. Procedure

1. With the patient appropriately prepped and anesthetized, the provider inserts a cystoscope into the urethra and slowly advances it into the bladder.
2. The provider examines the urethra, prostatic urethra (in men), and the lining of the bladder using the camera attached to the cystoscope.
3. Sterile saline water may be injected into the bladder to improve the view of the bladder wall.
4. The provider uses specialized cutting instruments inserted through the cystoscope to incise one or both openings of the ureters where they enter the bladder.
5. Upon completion, the provider removes the instruments and scope and drains the bladder.

4. Qualifying circumstances

CPT 52290 is performed on patients who require inspection and potential incision of the ureteral openings during cystourethroscopy. This procedure may be necessary for conditions such as ureteral strictures or other abnormalities affecting the ureters. It is important to note that this code can be used for both unilateral and bilateral procedures.

5. When to use CPT code 52290

CPT code 52290 should be used when the provider performs cystourethroscopy with the specific intention of performing a ureteral meatotomy. This code is appropriate when the provider inspects the urethra, prostatic urethra (in men), the interior of the bladder, and incises one or both openings of the ureters.

6. Documentation requirements

To support a claim for CPT 52290, the provider must document the following information:

• Patient’s diagnosis or condition necessitating the procedure
• Details of the cystourethroscopy procedure, including the use of a cystoscope and any additional instruments
• Specific findings during the inspection of the urethra, prostatic urethra (in men), and bladder
• Incision of one or both openings of the ureters, if applicable
• Date and duration of the procedure
• Any additional relevant information or complications encountered during the procedure

7. Billing guidelines

When billing for CPT 52290, it is important to ensure that the procedure performed aligns with the specific requirements of the code. This includes the inspection of the urethra, prostatic urethra (in men), the interior of the bladder, and the incision of one or both openings of the ureters. Modifier 50 is not necessary for reporting bilateral procedures. It is also important to review any specific guidelines or requirements from the payer to ensure accurate billing.

8. Historical information

CPT 52290 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 ureteral meatotomy on a patient with bilateral ureteral strictures.
2. A patient with a history of recurrent urinary tract infections undergoes cystourethroscopy with ureteral meatotomy to address a suspected anatomical abnormality.
3. A urologist performs cystourethroscopy with ureteral meatotomy on a patient with bladder stones and ureteral obstruction.
4. A patient with a history of kidney stones undergoes cystourethroscopy with ureteral meatotomy to improve urine flow and prevent future stone formation.
5. A urologist performs cystourethroscopy with ureteral meatotomy on a patient with a suspected ureteral stricture causing urinary flow obstruction.
6. A patient with a history of bladder cancer undergoes cystourethroscopy with ureteral meatotomy as part of their surveillance and treatment plan.
7. A urologist performs cystourethroscopy with ureteral meatotomy on a patient with recurrent urinary incontinence and suspected ureteral involvement.
8. A patient with a history of ureteral strictures undergoes cystourethroscopy with ureteral meatotomy to improve urine flow and alleviate symptoms.
9. A urologist performs cystourethroscopy with ureteral meatotomy on a patient with a suspected ureteral stone causing urinary obstruction.