How To Use CPT Code 52346

CPT 52346 describes a specific procedure involving cystourethroscopy and ureteroscopy for the treatment of intra-renal stricture. This article will provide an overview of the code, 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 52346?

CPT 52346 is a code used to describe a procedure that combines cystourethroscopy and ureteroscopy for the treatment of intra-renal stricture. This procedure involves the use of a cystoscope and a ureteroscope to inspect and treat the narrowing within the intrarenal structures. It is important to note that this code should not be used for transurethral resection or incision of ejaculatory ducts, as a separate code (52402) should be used for that specific procedure.

2. Official Description

The official description of CPT code 52346 is: ‘Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision).’ It is important to note that this code should not be reported in conjunction with code 52351, and that image-guided dilation of the ureter without endoscopic guidance should be reported with code 50706.

3. Procedure

1. The provider begins the procedure by inserting a cystoscope into the urethra and slowly advancing it into the bladder.
2. Once the cystoscope is in place, the provider uses a camera attached to the cystoscope to inspect the bladder, urethra, prostatic urethra, and ureteric openings.
3. To improve the view of the bladder wall, the provider may inject sterile saline water into the bladder.
4. The provider then advances a ureteroscope into the ureters and up into the renal pelvis to identify the presence of an intra-renal stricture.
5. Using various methods such as balloon dilation, laser, electrocautery, or incision, the provider treats the stricture and increases the diameter of the duct.
6. Once the treatment is complete, the provider removes the scope and other instruments and drains the bladder.

4. Qualifying circumstances

CPT 52346 is used for patients with intra-renal strictures that require treatment. It is important to note that this code should not be reported with codes 52344, 52345, or 52351. Additionally, for image-guided dilation of the ureter without endoscopic guidance, code 50706 should be used instead. It is crucial that the provider accurately documents the presence of the intra-renal stricture and the specific treatment method used.

5. When to use CPT code 52346

CPT code 52346 should be used when a provider performs cystourethroscopy and ureteroscopy to treat an intra-renal stricture. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure does not involve the treatment of an intra-renal stricture, a different code should be used.

6. Documentation requirements

To support a claim for CPT code 52346, the provider must document the following information:

• Presence of an intra-renal stricture
• Specific treatment method used (balloon dilation, laser, electrocautery, incision)
• Date of the procedure
• Start and end time of the procedure
• Any additional details or complications encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 52346, it is important to ensure that the procedure meets the specific criteria outlined in the code description. This code should not be reported in conjunction with code 52351. Additionally, image-guided dilation of the ureter without endoscopic guidance should be reported with code 50706. It is also important to follow any specific billing guidelines provided by the payer. It is recommended to check with the payer before submitting the claim to ensure proper reimbursement.

8. Historical information

CPT code 52346 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs cystourethroscopy with ureteroscopy and treats an intra-renal stricture using balloon dilation.
2. During a procedure, a provider uses cystourethroscopy with ureteroscopy to treat an intra-renal stricture using laser therapy.
3. A patient undergoes cystourethroscopy with ureteroscopy for the treatment of an intra-renal stricture using electrocautery.
4. A provider performs cystourethroscopy with ureteroscopy and treats an intra-renal stricture through incision.
5. During a procedure, a provider uses cystourethroscopy with ureteroscopy to treat an intra-renal stricture using a combination of treatment methods.