How do I bill for a cystoscopy with retrograde pyelogram performed on both ureters?
A. Billing rules are different between Medicare and commercial insurers. According to the Medicare Carriers Manual, Section 15200, there are specific instructions for billing a bilateral retrograde pyelogram: Cystourethroscopy with ureteral catheterization with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service (CPT® code 52005) – there is no payment adjustment for bilateral procedures because the basic procedure is an examination of the bladder and urethra (cystourethroscopy) which are not paired organs. The work relative value units (RVU) assigned take into account that it may be necessary to examine and catheterize one or both ureters. No additional payment is made when the procedure is billed with modifier -50, Bilateral. Commercial carriers may have their own rules on coding bilateral retrogrades. Contact your carrier to determine their billing requirements. back to top Urological Surgery Procedures Q. A cystectomy and continent diversion w
