How To Use CPT Code 52327

CPT 52327 describes a specific procedure involving cystourethroscopy and the subureteric injection of implant material. 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 52327?

CPT 52327 is a code used to describe a procedure that involves cystourethroscopy and the subureteric injection of implant material. This procedure is performed by a healthcare provider to prevent the backflow of urine from the bladder into the ureter, a condition known as vesicoureteral reflux. The provider uses a cystoscope to inspect the interior of the bladder, urethra, prostatic urethra, and ureteric openings. They then insert a catheter into the ureteral opening and inject an implant material below the opening to prevent reflux.

2. Official Description

The official description of CPT code 52327 is: ‘Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material.’

3. Procedure

1. The healthcare provider prepares the patient and ensures they are appropriately anesthetized.
2. Using a cystoscope, the provider inserts the tip into the urethra and slowly advances it into the bladder.
3. The provider examines the urethra and injects sterile saline water into the bladder to improve visibility.
4. The provider then advances the catheter tip into each ureteral orifice to outline the opening.
5. Through the catheter, the provider injects an implant material, such as dextranomer/hyaluronic acid copolymer, beneath the opening of the ureter to prevent reflux.
6. After completing the procedure, the provider performs a final inspection, drains the bladder, and removes the cystoscope and any other instruments.

4. Qualifying circumstances

CPT 52327 is performed on patients who require the prevention of vesicoureteral reflux. This procedure is typically performed by urologists or other qualified healthcare providers. It is important to note that the code does not clearly indicate if it is appropriate to use modifier 50 (Bilateral procedure) for cystourethroscopic procedures involving the ureters. It is recommended to check with the payer before billing to ensure proper reimbursement.

5. When to use CPT code 52327

CPT code 52327 should be used when a healthcare provider performs cystourethroscopy and subureteric injection of implant material to prevent vesicoureteral reflux. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 52327, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the procedure
• Details of the cystourethroscopy, including the use of a cystoscope and catheterization of the ureteral openings
• Specific implant material used for the subureteric injection
• Date and duration of the procedure
• Any additional relevant information or findings
• Provider’s signature

7. Billing guidelines

When billing for CPT 52327, it is important to ensure that the procedure meets the specific criteria outlined in the code description. It is also important to follow any additional guidelines provided by the payer. Modifier 50 (Bilateral procedure) may or may not be appropriate for cystourethroscopic procedures involving the ureters, depending on the payer’s rules. It is recommended to check with the payer before billing to ensure proper reimbursement.

8. Historical information

CPT 52327 was added to the Current Procedural Terminology system on January 1, 1995. There have been no updates to the code since its addition.

9. Examples

1. A urologist performing cystourethroscopy and subureteric injection of implant material to prevent vesicoureteral reflux in a patient with recurrent urinary tract infections.
2. A healthcare provider using a cystoscope to inspect the bladder and urethra, and then injecting an implant material beneath the ureteral opening to prevent reflux in a patient with a history of kidney stones.
3. A urologist performing cystourethroscopy and subureteric injection of implant material to prevent vesicoureteral reflux in a pediatric patient with urinary incontinence.
4. A healthcare provider using a cystoscope to examine the bladder and urethra, and then injecting an implant material beneath the ureteral opening to prevent reflux in a patient with a neurogenic bladder.
5. A urologist performing cystourethroscopy and subureteric injection of implant material to prevent vesicoureteral reflux in a patient with a history of bladder cancer.
6. A healthcare provider using a cystoscope to inspect the bladder and urethra, and then injecting an implant material beneath the ureteral opening to prevent reflux in a patient with a congenital urinary tract abnormality.
7. A urologist performing cystourethroscopy and subureteric injection of implant material to prevent vesicoureteral reflux in a patient with a history of kidney transplant.