How To Use CPT Code 52352

CPT 52352 describes the procedure of cystourethroscopy, with ureteroscopy and/or pyeloscopy, including the removal or manipulation of a calculus. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 52352?

CPT 52352 is used to describe a specific procedure involving cystourethroscopy, ureteroscopy, and/or pyeloscopy. This procedure includes the removal or manipulation of a calculus, which is a stone that may be causing obstruction or other issues within the urinary tract.

2. Official Description

The official description of CPT code 52352 is: ‘Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)’. This code encompasses the comprehensive examination and treatment of the urinary tract, specifically focusing on the removal or repositioning of a calculus.

3. Procedure

1. The healthcare provider begins by inserting a cystourethroscope, a specialized instrument with a camera, through the urethra and into the bladder.
2. Using the camera attached to the cystourethroscope, the provider carefully examines the bladder, urethra, prostatic urethra, and ureteric openings to identify any abnormalities or calculi.
3. If a calculus is found in the ureter or renal pelvis, the provider may switch to a ureteroscope or pyeloscope to further investigate and treat the stone.
4. The provider then removes or manipulates the calculus, either by breaking it down or repositioning it to allow for natural passage or to alleviate obstruction.
5. If necessary, the provider may perform additional procedures, such as irrigation, to ensure the complete removal of any stone fragments.
6. Once the procedure is complete, the provider removes the instruments and ensures proper drainage of the bladder.

4. Qualifying circumstances

CPT 52352 is performed on patients who have been diagnosed with a calculus within their urinary tract. This procedure is typically reserved for cases where the calculus is causing obstruction or other complications. It is important to note that ureteral catheterization is included in this code, meaning that the provider may insert a catheter into the ureter during the procedure.

5. When to use CPT code 52352

CPT code 52352 should be used when a healthcare provider performs cystourethroscopy, ureteroscopy, and/or pyeloscopy with the specific intention of removing or manipulating a calculus. This code is appropriate when the procedure involves the examination and treatment of the urinary tract, focusing on the removal or repositioning of a stone. It is important to ensure that the documentation supports the use of this code and clearly indicates the presence of a calculus and the performed manipulations.

6. Documentation requirements

To support a claim for CPT 52352, the healthcare provider must document the following information:

• Patient’s diagnosis of a calculus within the urinary tract
• Details of the cystourethroscopy, ureteroscopy, and/or pyeloscopy performed
• Description of the removal or manipulation of the calculus
• Use of ureteral catheterization, if applicable
• Any additional procedures performed, such as irrigation
• Documentation of proper drainage of the bladder

7. Billing guidelines

When billing for CPT 52352, it is important to ensure that the documentation supports the use of this code and clearly indicates the presence of a calculus and the performed manipulations. Additionally, it is crucial to follow any specific guidelines provided by payers regarding the use of modifier 50 (Bilateral procedure) for cystourethroscopic procedures involving the ureters or kidneys. It is recommended to check with the payer before billing to ensure proper reimbursement.

8. Historical information

CPT 52352 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 urologist performs cystourethroscopy, ureteroscopy, and pyeloscopy on a patient with a ureteral calculus. The calculus is successfully removed, and the patient’s symptoms are alleviated.
2. During a cystourethroscopy procedure, a urologist discovers a renal pelvis calculus. The calculus is manipulated into a position where it can pass naturally, avoiding the need for further intervention.
3. A patient presents with recurrent urinary tract infections due to a bladder calculus. The urologist performs cystourethroscopy and removes the calculus, providing relief for the patient.
4. During a routine cystourethroscopy, a urologist identifies a urethral calculus. The calculus is broken down using laser surgery, and the patient is able to pass the fragments without complications.
5. A patient with a history of kidney stones undergoes cystourethroscopy, ureteroscopy, and pyeloscopy. The urologist identifies and removes a calculus from the renal pelvis, preventing future obstructions.