march 2009

Transurethral Resection of Prostate (TURP)

In last month’s newsletter I mentioned that some CPT codes in the Urinary System section were deleted and others were revised. The results of these changes are that the deleted services are now reported with a different CPT code and modifiers are appended to identify the stage or postoperative period. Let’s explore this a little further.
TURP or transurethral resection of the prostate are the codes that have undergone these changes.

52606-transurethral fulguration for postop bleeding occurring after the usaual follow-up time has been deleted and is now reported with 52214-Cystourethroscopy with fulguration.

The reason for revising this next set of codes was to reflect current medical practices. With advances in technology it is no longer necessary to perform a TURP in two stages as indicated by the old CPT codes 52612-(first stage of two stage resection) and 52614-(second stage of two stage resection)which have been deleted. If however, the two stage procedure is performed for the first stage partial TURP report 52601 and for second stage partial TURP report 52601-58.

Due to the fact that CPT codes 52620-resection of residual obstructive tissue and 52630-resection of regrowth of obstructive tissue require the same amount of physician work and equivalent techniques these two codes have been combined with CPT code 52620 being deleted. This procedure is now reported as 52630 with the new descriptor reading “ transurethral resection of residual or regrowth of obstructive prostate tissue including control of postop bleeding complete”. If the residual prostate tissue is resected during the postoperative period by the same physician then append modifier 78 (52630-78).