2025 CPT code 52234

Cystourethroscopy with fulguration (including cryosurgery or laser surgery) and/or resection of small bladder tumors (0.5 to 2.0 cm).

Follow current CPT guidelines for cystoscopy and the treatment of bladder tumors. Accurate documentation of lesion size is crucial for selecting the correct code. For Medicare, only one code should be reported per encounter regardless of the number of tumors treated.

Modifiers may be applicable depending on the circumstances of the procedure (e.g., 59 for distinct procedural service, 22 for increased procedural services, etc.).

Medical necessity for this procedure is established by the presence of symptomatic or asymptomatic bladder tumors requiring treatment.The size of the tumor dictates the choice of code.Pre-operative and post-operative care should be well documented.

The urologist or a qualified healthcare provider performs the procedure. Responsibilities include patient preparation (including anesthesia), insertion of the cystoscope, examination of the bladder and urethra, removal/destruction of the lesion(s), and post-procedure care.

IMPORTANT 52224 (for lesions <0.5cm), 52235 (for tumors 2.0-5.0cm), 52240 (for tumors >5.0cm).Code selection depends on the size of the bladder tumor(s).

In simple words: The doctor uses a thin, lighted tube (cystoscope) inserted into the urethra to examine the bladder and urethra.Any small bladder tumors (between 0.5 and 2.0 cm) are removed or destroyed using electricity, freezing, or laser treatment.

This procedure involves the endoscopic examination of the urethra, prostatic urethra (in males), bladder interior, and ureteric orifices using a cystoscope.Small bladder tumors ranging from 0.5 cm to 2.0 cm in size are destroyed using high-intensity electric current (fulguration), intense cold (cryosurgery), or intense heat (laser surgery). The procedure may include resection of the tumor.

Example 1: A 65-year-old male presents with hematuria and cystoscopy reveals a 1.0 cm bladder tumor.The tumor is fulgurated using electrocautery., A 72-year-old female presents with bladder irritation and cystoscopy reveals two small, 0.7 cm bladder tumors.Both tumors are resected using laser surgery., A 58-year-old male with a history of bladder cancer undergoes a follow-up cystoscopy which reveals a 1.5 cm tumor.The tumor is treated with cryosurgery.

Complete medical history, physical examination findings, cystoscopic findings (including location, size, and number of lesions), procedure report specifying the method of destruction or resection (fulguration, cryosurgery, laser surgery), pathology report (if tissue was removed), and any post-operative complications.

** This code may be used with other codes for biopsy or other procedures performed during the same cystoscopy.Always check payer-specific guidelines for billing rules and restrictions.

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