TURP CPT code

TURP CPT Code (2022) Description, Guidelines, Reimbursement, Modifiers & Examples

TURP CPT code 52601 is used for a transurethral resection of the prostate surgery operation. The meaning of “complete,” the work associated with the code, and what may include and not individually chargeable are critical in understanding what the code descriptor means. 

Summary

The most prevalent indication for this surgery is benign (noncancerous) prostate enlargement. Because of recent breakthroughs in medication therapy, many people no longer require this operation. Misunderstanding the descriptor’s language could result in incorrect billing and denial of payment.

CPT® 52601, which the American Medical Association maintains, is a medical procedure code for vesical neck and prostate surgery (AMA). It includes other urological surgery procedures such as urethral dilatation, meatotomy, and cystoscopy. These surgeries cannot report because they are part of the TURP surgery.

Only males have the prostate, a tiny gland in the pelvic. During transurethral resection of the prostate surgery, surgeons remove a portion of the prostate (TURP). The urethra encloses by the penis, while the urethra ring surrounds the bladder.

The most prevalent reason for TURP treatment is an enlarged prostate. It could be because of a disorder called benign prostatic hyperplasia. BPH does not cause cancer. It’s a common side effect of becoming older. An enlarged prostate gland can pressure the urethra, preventing urine from adequately exiting the body.

CPT code 52601 denotes a TURP operation for resecting prostate tissue utilizing a cystourethroscopic technique in men with urinary obstruction at the prostate level (although it can use for other reasons, such as for a prostatic abscess).

This CTP code may facilitate the patient for urological surgery for male patients. Many CTP codes use for TRUP surgery.

The prostate, a tiny gland in the pelvis, is only found in men—the urethra border by the penis and the bladder by the urethra ring. When the prostate grows, it can pressure the urethra and bladder. Urinary incontinence is a typical sign of this illness.

A resectoscope, a small metal tube containing a light, camera, and a wire loop, is used to perform TURP. The urethra and prostate are the only access routes for this surgery, removing the need for skin incisions.

The heated loop of wire, which may heat with an electric current, is then used to remove the piece of your prostate, causing you pain. An intra-urethral catheter may insert to remove any remaining excised prostate tissue and pump liquids into your bladder.

The only reason for doing a TURP is to address illness symptoms. If you have prostate cancer but are unable to have it surgically removed, a TURP procedure may be necessary.

cpt code for turp

TURP CPT Code Description

Code CPT 52601 refers to a cystourethroscopic treatment for resecting prostate tissue in males with urinary obstruction at the urethral level (although it can use for other reasons, such as for a prostatic abscess). 

The amount of tissue that can remove to improve a patient’s voiding parameters in a single surgery must be appropriate and necessary for CPT code 52601 without a modifier unless a two-stage procedure may schedule in advance due to the size of the prostate.

 Removing all prostate tissue or resecting only the prostatic capsule is not required to report a TURP without a modifier. This code demonstrates that not all of the tissue may remove to apply CPT code 52601. 

CPT code 52601 does not require a reduced services modifier and may bill for the operations specified in parenthesis. The parentheses indicate that some functions may not be eligible for separate reimbursement when performed concurrently with CPT code 52601.

To define TURP procedures, code descriptors and parenthesis may utilize, which may currently record using two CPT codes. It is the elimination of (52612, 52614, and 52620). In the first stage, use 52601 to accomplish a partial transurethral resection of the prostate.

Using CPT 52601 with modifier 58 will require prostate resection’s second step. Any leftover or regrowing obstructive prostate tissue can eliminate transurethrally using CPT 52630.

The remaining prostate tissue may remove following a similar treatment conducted by a different doctor (append modifier 78). Initially, TURP procedures will report using five (5) CPT codes:

CPT 52601: comprehensive (includes vasectomy, meatotomy, cystourethroscopy, urethral calibration and dilatation, and internal urethroscopy). Postoperative hemorrhage control following transurethral electrosurgical prostate removal

CPT 52612: Transurethral resection of the prostate is the first step in a two-stage resection (partial resection). Prostate transurethral resection in two phases: 52614 is the zip code in question (resection completed)

cpt code turp

CPT 52620: Removal of any obstructing tissue via the urethra CPT 52630 90 days after surgery. Transurethral resection is required to eliminate blockage tissue that has been regrowing for more than a year.

CPT 52620

 If the prostate was too large to accomplish the resection objectives in a single procedure, postoperative CPT codes 52612 and 514 might indicate two-stage TURP surgeries. The first stage of the TURP may report using CPT code 52612, and the second stage (to “complete” the TURP) may use CPT code 52614, with Modifier 58 applied if conducted during the postoperative global period, if appropriate.

As a result, the word “complete” was added to CPT code 52601 to represent the surgeon’s intention to perform surgery only once, as opposed to performing an incomplete operation (CPT 52602) and completing the procedure (CPT 52604) at a different site. 

Later, the CPT codes 52612 and 52614 may remove since they were extraneous; the remaining codes are still adequate to define the process, even if it is performed simultaneously in two locations. If the double-stage procedure may perform unexpectedly, CPT code 52630 will utilize. 

Because the initial treatment was partial, CPT codes 52620 and 52630 may note if the patient required more resection due to subsequent tissue regrowth. CPT codes 52620 and 52630 were later judged to have contributed to coding ambiguity and may think to have overlapped and repeated. Thus, a subordinate with coding guidance may also include.

TURP CPT Code Billing Guidelines

The operations described in CPT codes 52601 and 52630 are included if accomplished but are not required to charge the code as-is. Vasectomies, meatotomies, cystourethroscopies, urethral calibration or dilatation, or internal urethrotomy may not need. Even if these operations may be complete, they will not code separately. 

Vasectomies and TURPs were performed in tandem to limit the likelihood of recurrence into the vas deferent and epididymis. CPT code 52601 may not require any of the operations listed in parenthesis, although they cannot bill if performed concurrently.

When a patient brings into the operating room to remove as much prostate tissue as possible to enhance the patient’s voiding characteristics, CPT code 52601 should be utilized (without a modifier). The word “complete” may never intend to indicate a requirement for tissue removal. Hence this interpretation is incorrect. 

Because it is in the doctor’s best interest to remove the tissue necessary to improve patient outcomes when billing a TURP, the completion of a TURP will note in the body of the operational note rather than the description.

TURP CPT Code Modifiers

When reporting findings, surgeons must be truthful and accurate. A modifier 52 will introduce the code to indicate that the TURP may decommission (if appropriate). A “channel TURP” and tumor removal are two instances of confined resections (a limited resection of prostate tissue after the radiation therapy to improve voiding characteristics while lowering the risk of incontinence). 

In these cases, a decreased services modifier is still at the surgeon’s choice, but it is not required because the procedure’s indication requires it. If the surgeon believes the removed tissue and the operation were important enough, surgery code CPT 52601 does not require a modifier.

 It is within their professional and ethical boundaries. It should be clear from the surgeon’s notes. Regarding services that may cancel or terminate, modifier 52 is the same as modifier 53. There’s a big difference between the proper use of these two modifiers, even if they may use in the same context. 

If you’re unsure how to use these two modifications, you may end up underpaying or rejecting your claim. Now that we’ve reviewed modification 53, let’s look at modifier 52 and how it may use.

Modifier 52 cannot use when the provider unexpectedly reduces services. Thus, you must know why the provider is cutting back to apply it to the claim correctly—a better understanding of why something may assist you in determining which modifier to employ. As with most modifiers, this serves as a helpful reminder.

The modifiers used for the TURP CPT code are 53 and 52

TURP CPT Code Reimbursement

Payment for a 90-day global procedure includes the cost of the system, as well as any necessary follow-up care. Typically, this work contains one day of preoperative work, one day of actual surgery, and 90 days of follow-up work. 

Patients who come in for regular checkups do not automatically necessitate a PVR during their ordinary recuperation from TURP. It is possible to bill for CPT 51798 if the procedure may perform because the patient shows evidence of urinary retention.

Example

If a patient can still not empty his bladder following an initial procedure, they will need another TURP to remove any remaining obstructions. Ferragamo recommends Code 52630-78 for this situation. In this case, the second TURP for recurrent prostatic development (such as after a year) will be coded CPT 52630 without a modifier,” he explains.

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