How To Use CPT Code 52342

CPT 52342 describes the treatment of a ureteropelvic junction stricture using cystourethroscopy. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 52342?

CPT 52342 is used to describe the treatment of a ureteropelvic junction (UPJ) stricture using cystourethroscopy. This procedure involves the insertion of a cystoscope through the urethra and into the bladder to inspect the interior of the bladder, urethra, prostatic urethra, and ureteric openings. The provider then treats the UPJ stricture using various methods such as balloon dilation, laser, electrocautery, or incision.

2. Official Description

The official description of CPT code 52342 is: ‘Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)’

3. Procedure

1. The provider inserts a cystoscope into the urethra and advances it into the bladder.
2. The provider examines the urethra and injects sterile saline water into the bladder to improve the view of the bladder wall.
3. The provider continues to advance the cystoscope into the ureters and identifies a stricture at the ureteropelvic junction (UPJ).
4. The provider selects the appropriate method to treat the UPJ stricture, such as balloon dilation, laser, electrocautery, or incision.
5. The provider performs the chosen treatment to increase the diameter of the ureter and alleviate the stricture.
6. Once the procedure is complete, the provider removes the cystoscope and any other instruments used and drains the bladder.

4. Qualifying circumstances

CPT 52342 is used for patients with a ureteropelvic junction (UPJ) stricture. This condition involves a narrowing at the junction of the ureter and the renal pelvis. The procedure is performed by a provider using cystourethroscopy, and various treatment methods can be used to address the stricture, such as balloon dilation, laser, electrocautery, or incision.

5. When to use CPT code 52342

CPT code 52342 should be used when a provider performs cystourethroscopy to treat a ureteropelvic junction (UPJ) stricture. This code is appropriate when the procedure involves the use of methods such as balloon dilation, laser, electrocautery, or incision to alleviate the stricture. It is important to ensure that the documentation supports the use of this code for the specific treatment performed.

6. Documentation requirements

To support a claim for CPT code 52342, the provider must document the following information:

• Patient’s diagnosis of a ureteropelvic junction (UPJ) stricture
• Specific treatment method used, such as balloon dilation, laser, electrocautery, or incision
• Date of the procedure
• Details of the procedure, including the use of cystourethroscopy and any other instruments
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 52342, ensure that the procedure involves the treatment of a ureteropelvic junction (UPJ) stricture using cystourethroscopy. The appropriate treatment method, such as balloon dilation, laser, electrocautery, or incision, should be documented. It is important to follow payer-specific guidelines and modifiers, if applicable, to ensure proper reimbursement. Additionally, it is recommended to check with the payer before billing to ensure compliance with their specific rules and requirements.

8. Historical information

CPT code 52342 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates to the code since its addition.

9. Examples

1. A provider performs cystourethroscopy to treat a ureteropelvic junction (UPJ) stricture using balloon dilation.
2. A patient undergoes cystourethroscopy for the treatment of a UPJ stricture using laser therapy.
3. A provider uses cystourethroscopy to treat a UPJ stricture with electrocautery.
4. A patient receives cystourethroscopy for the treatment of a UPJ stricture with incision.
5. A provider performs cystourethroscopy to treat a UPJ stricture using a combination of balloon dilation and laser therapy.
6. A patient undergoes cystourethroscopy for the treatment of a UPJ stricture using a combination of electrocautery and incision.
7. A provider uses cystourethroscopy to treat a UPJ stricture with balloon dilation followed by laser therapy.
8. A patient receives cystourethroscopy for the treatment of a UPJ stricture with electrocautery followed by incision.
9. A provider performs cystourethroscopy to treat a UPJ stricture using laser therapy followed by balloon dilation.
10. A patient undergoes cystourethroscopy for the treatment of a UPJ stricture using incision followed by electrocautery.