How To Use CPT Code 52305

CPT 52305 describes the procedure of cystourethroscopy with incision or resection of the orifice of a bladder diverticulum. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 52305?

CPT 52305 can be used to describe a specific surgical procedure known as cystourethroscopy with incision or resection of the orifice of a bladder diverticulum. This code is utilized when a healthcare provider uses a cystoscope to inspect the urethra, prostatic urethra (in men), the interior of the bladder, and ureteric openings. During the procedure, the provider incises or resects the opening of one or more bladder diverticula, which are abnormal pouches in the bladder wall.

2. Official Description

The official description of CPT code 52305 is: ‘Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple.’

3. Procedure

1. The healthcare provider inserts a cystoscope into the urethra and navigates it into the bladder.
2. Using the camera attached to the cystoscope, the provider examines the urethra and injects sterile saline water into the bladder to enhance the view of the bladder wall.
3. During the examination, the provider identifies one or more diverticula in the bladder wall.
4. Using specialized instruments passed through the cystoscope, the provider either cuts into the opening of the diverticulum or removes the opening, allowing the pouch to flatten out like the rest of the bladder wall.
5. After treating all the diverticula, the provider inspects the areas and controls any bleeding.
6. Finally, the provider drains the bladder, withdraws the cystoscope, and any other instruments used during the procedure.

4. Qualifying circumstances

CPT 52305 is performed on patients who have bladder diverticula, which are abnormal pouches in the bladder wall. The procedure is typically done under anesthesia. The healthcare provider must use a cystoscope to visualize and access the diverticulum. The incision or resection of the orifice of the bladder diverticulum is necessary to flatten out the pouch and restore normal bladder function.

5. When to use CPT code 52305

CPT code 52305 should be used when a healthcare provider performs cystourethroscopy with incision or resection of the orifice of a bladder diverticulum. It is important to accurately document the procedure and ensure that it meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 52305, the healthcare provider must document the following information:

• Patient’s diagnosis of bladder diverticulum
• Details of the cystourethroscopy procedure
• Specific diverticulum(s) treated
• Method used for incision or resection
• Any additional procedures performed during the same session
• Any complications or adverse events encountered
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 52305, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the procedure and any additional services provided during the same session. Be aware of any bundling or unbundling rules that may apply to the specific circumstances of the procedure.

8. Historical information

CPT 52305 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 incision of a bladder diverticulum in a patient with recurrent urinary tract infections.
2. A surgeon conducting cystourethroscopy with resection of multiple bladder diverticula in a patient with bladder dysfunction.
3. An interventional radiologist performing cystourethroscopy with incision of a bladder diverticulum in a patient with hematuria.
4. A urogynecologist conducting cystourethroscopy with resection of a bladder diverticulum in a patient with urinary incontinence.
5. A pediatric urologist performing cystourethroscopy with incision of a bladder diverticulum in a child with voiding dysfunction.
6. A urologic oncologist conducting cystourethroscopy with resection of multiple bladder diverticula in a patient with bladder cancer.
7. An interventional radiologist performing cystourethroscopy with incision of a bladder diverticulum in a patient with neurogenic bladder.
8. A urogynecologist conducting cystourethroscopy with resection of a bladder diverticulum in a patient with pelvic organ prolapse.
9. A urologist performing cystourethroscopy with incision of a bladder diverticulum in a patient with bladder stones.
10. An interventional radiologist conducting cystourethroscopy with resection of multiple bladder diverticula in a patient with recurrent urinary retention.