How To Use CPT Code 53260

CPT 53260 describes the excision or fulguration of urethral polyps using either surgical removal or electric current. 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 53260?

CPT 53260 is used to describe the excision or fulguration of urethral polyps. This procedure involves the removal of abnormal growths that originate from the mucous lining of the urethra. The provider may either surgically remove the polyp or use electric current to destroy and remove the tissue. The purpose of this procedure is to improve urination and relieve pain in both male and female patients.

2. Official Description

The official description of CPT code 53260 is: ‘Excision or fulguration; urethral polyp(s), distal urethra.’ This code specifically refers to the removal or destruction of urethral polyps located in the distal part of the urethra. It is important to note that for an endoscopic approach, a different CPT code should be used.

3. Procedure

1. The provider prepares and anesthetizes the patient, ensuring their comfort and safety throughout the procedure.
2. For female patients, the provider makes a small incision in the anterior vaginal wall to access the distal part of the urethra.
3. The provider separates the urethra from the vaginal wall and identifies the urethral polyp.
4. Using either surgical excision or electrocautery, the provider removes or destroys the polyp.
5. A catheter may be inserted into the urethra to promote healing and assist with drainage.
6. The provider controls any bleeding and closes the incision in layers.

4. Qualifying circumstances

CPT 53260 is performed on patients who have urethral polyps that require removal or destruction. These polyps can cause urinary difficulties and pain. The procedure can be performed on both male and female patients. It is important to note that the polyps must be located in the distal part of the urethra for this code to be applicable.

5. When to use CPT code 53260

CPT code 53260 should be used when a provider performs the excision or fulguration of urethral polyps located in the distal urethra. It is important to ensure that the polyps meet the criteria for removal or destruction and that the procedure is performed in the appropriate location.

6. Documentation requirements

To support a claim for CPT 53260, the provider must document the following information:

• Patient’s diagnosis and the need for polyp removal or destruction
• Details of the procedure, including the approach used (surgical excision or electrocautery)
• Date of the procedure
• Any additional procedures performed during the same session
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 53260, ensure that the procedure meets the criteria for excision or fulguration of urethral polyps located in the distal urethra. It is important to follow the specific documentation requirements and guidelines provided by the payer. Additionally, be aware of any bundling or unbundling issues that may affect the billing of this code.

8. Historical information

CPT 53260 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 female patient undergoes excision of a urethral polyp located in the distal urethra to alleviate urinary difficulties.
2. A male patient undergoes fulguration of a urethral polyp located in the distal urethra to relieve pain during urination.
3. A provider performs surgical excision of multiple urethral polyps in a female patient’s distal urethra to improve urinary flow.
4. A male patient undergoes fulguration of a single urethral polyp located in the distal urethra to address recurrent urinary tract infections.
5. A female patient undergoes excision of a large urethral polyp in the distal urethra to alleviate discomfort and improve urination.
6. A provider performs fulguration of a small urethral polyp in a male patient’s distal urethra to address urinary frequency.
7. A female patient undergoes surgical excision of a urethral polyp located in the distal urethra to address recurrent hematuria.
8. A male patient undergoes fulguration of a urethral polyp located in the distal urethra to alleviate pain and improve urinary flow.
9. A provider performs excision of multiple urethral polyps in a female patient’s distal urethra to address recurrent urinary tract infections.
10. A male patient undergoes fulguration of a single urethral polyp located in the distal urethra to alleviate discomfort during urination.