How To Use CPT Code 52317

CPT 52317 describes the procedure of litholapaxy, which involves the crushing or fragmentation of a small stone in the bladder and the subsequent removal of the fragments. This article will provide an overview of CPT code 52317, 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 52317?

CPT 52317 is used to describe the procedure of litholapaxy, which involves the crushing or fragmentation of a small stone in the bladder and the subsequent removal of the fragments. This code is specifically used when the stone is simple or small, measuring less than 2.5 cm in diameter.

2. Official Description

The official description of CPT code 52317 is: ‘Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm).’ This code is used when the provider performs a cystourethroscopy to inspect the interior of the bladder, urethra, prostatic urethra, and ureteric openings. The provider then localizes, crushes, and removes the small stone or its fragments.

3. Procedure

1. The provider begins by inserting a well-lubricated flexible or rigid cystourethroscope through the external opening of the urethra.
2. Using the cystourethroscope, the provider examines the urethra and bladder to locate the exact position of the stone.
3. Once the stone is localized, the provider inserts lithotripter equipment, typically an ultrasonic lithotripter, through the cystourethroscope.
4. The provider then uses the lithotripter equipment to deliver shock waves to the stone, effectively crushing it.
5. After the stone is broken, the provider irrigates the bladder to wash out the remaining fragments of the stone.
6. Using the cystourethroscope, the provider confirms the complete removal of the stone and withdraws the scope.

4. Qualifying circumstances

CPT 52317 is used when the provider crushes and removes a small stone or its fragments that are less than 2.5 cm in diameter. It is important to note that this code is specifically for simple or small stones. If the stone is complicated or large, measuring over 2.5 cm, a different code, such as CPT 52318, should be used.

5. When to use CPT code 52317

CPT code 52317 should be used when the provider performs litholapaxy to crush and remove a small stone or its fragments that are less than 2.5 cm in diameter. It is important to accurately document the size of the stone and ensure that it meets the criteria for a simple or small stone.

6. Documentation requirements

To support a claim for CPT 52317, the provider must document the following information:

• Size of the stone or its fragments, confirming that it is less than 2.5 cm in diameter
• Details of the cystourethroscopy, including the use of a flexible or rigid cystourethroscope
• Confirmation of the stone localization and the use of lithotripter equipment
• Documentation of the stone crushing process and the subsequent irrigation of the bladder
• Confirmation of the complete removal of the stone using the cystourethroscope

7. Billing guidelines

When billing for CPT 52317, it is important to ensure that the procedure meets the criteria for a simple or small stone. If the stone is complicated or large, a different code should be used. It is also important to follow any specific guidelines provided by the payer regarding the documentation and reporting of litholapaxy procedures.

8. Historical information

CPT code 52317 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 litholapaxy to crush and remove a small stone measuring less than 2.5 cm in diameter from a patient’s bladder.
2. A patient undergoes litholapaxy to have a small stone fragment removed from their bladder by a urologist.
3. A provider performs litholapaxy on a patient with a simple or small stone in their bladder, effectively crushing and removing the stone fragments.
4. A urologist uses litholapaxy to crush and remove a small stone from a patient’s bladder, ensuring complete removal of the stone fragments.
5. A patient undergoes litholapaxy to have a small stone fragment removed from their bladder by a provider, resulting in successful stone fragmentation and removal.