How To Use CPT Code 52325

CPT 52325 describes the procedure of cystourethroscopy with fragmentation of a ureteral calculus using techniques such as ultrasonic or electro-hydraulic lithotripsy. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 52325?

CPT 52325 can be used to describe the procedure of cystourethroscopy with fragmentation of a ureteral calculus. This code is used when a healthcare provider uses techniques such as ultrasonic or electro-hydraulic lithotripsy to break down and remove a stone from the ureter during a cystourethroscopy procedure.

2. Official Description

The official description of CPT code 52325 is: ‘Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)’

3. Procedure

1. The healthcare provider begins by inserting a cystoscope into the urethra and slowly advancing it into the bladder.
2. Using the camera attached to the cystoscope, the provider examines the bladder, urethra, prostatic urethra, and ureteral openings.
3. The provider injects sterile saline water into the bladder to improve the view of the bladder wall.
4. The provider then advances the tip of the catheter into each ureteral orifice.
5. If a calculus (stone) is observed at the ureteral orifice, the provider uses a technique such as ultrasonic or electro-hydraulic lithotripsy to fragment the stone.
6. The provider may use a grasping instrument inserted through the cystoscope to remove the stone fragments or irrigate the bladder to wash the fragments out.
7. Once the procedure is complete, the provider drains the bladder and removes the cystoscope and any other instruments.

4. Qualifying circumstances

CPT 52325 is performed on patients who have a ureteral calculus that requires fragmentation. The procedure is typically performed by a healthcare provider who specializes in urology. The use of techniques such as ultrasonic or electro-hydraulic lithotripsy is necessary to break down and remove the stone from the ureter.

5. When to use CPT code 52325

CPT code 52325 should be used when a healthcare provider performs cystourethroscopy with fragmentation of a ureteral calculus using techniques such as ultrasonic or electro-hydraulic lithotripsy. This code should be reported for each instance of the procedure performed.

6. Documentation requirements

To support a claim for CPT 52325, the healthcare provider must document the following information:

• Patient’s diagnosis indicating the presence of a ureteral calculus
• Details of the cystourethroscopy procedure performed
• Specific technique used for fragmentation (ultrasonic or electro-hydraulic lithotripsy)
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 52325, ensure that the procedure involves the fragmentation of a ureteral calculus using techniques such as ultrasonic or electro-hydraulic lithotripsy. It is important to follow the specific guidelines provided by the payer regarding the use of modifier 50 (Bilateral procedure) for cystourethroscopic procedures involving the ureters. It is recommended to check with the payer before submitting the claim to ensure proper reimbursement.

8. Historical information

CPT 52325 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 fragmentation of a ureteral calculus using ultrasonic lithotripsy for a patient with a stone in the left ureter.
2. A healthcare provider using electro-hydraulic lithotripsy during cystourethroscopy to fragment and remove a ureteral calculus in a patient with bilateral stones.
3. A urologist performing cystourethroscopy with ultrasonic lithotripsy to break down and remove a ureteral calculus in a patient with a history of recurrent kidney stones.
4. A healthcare provider using electro-hydraulic lithotripsy during cystourethroscopy to fragment and remove a large ureteral calculus causing urinary obstruction in a patient.
5. A urologist performing cystourethroscopy with ultrasonic lithotripsy to break down and remove a ureteral calculus in a patient with symptoms of renal colic.
6. A healthcare provider using electro-hydraulic lithotripsy during cystourethroscopy to fragment and remove a ureteral calculus in a patient with a history of urinary tract infections.
7. A urologist performing cystourethroscopy with ultrasonic lithotripsy to break down and remove a ureteral calculus in a patient with hydronephrosis.
8. A healthcare provider using electro-hydraulic lithotripsy during cystourethroscopy to fragment and remove a ureteral calculus in a patient with a history of bladder stones.