2025 CPT code 52240

Cystourethroscopy with fulguration, cryosurgery, or laser surgery, and/or resection of large bladder tumor(s) (greater than 5.0 cm).

Follow current CPT coding guidelines for surgical procedures and appropriate documentation for reimbursement.Refer to payer-specific guidelines.

Modifiers may be applicable depending on the circumstances, including but not limited to: 22 (increased procedural services), 51 (multiple procedures), 59 (distinct procedural service), and others as needed. Consult current CPT guidelines for detailed modifier application rules.

Medical necessity for this procedure is established by the presence of a large bladder tumor (≥5cm) causing symptoms such as hematuria, dysuria, frequency, urgency, or other obstructive symptoms.Imaging studies must confirm the presence, size, and location of the tumor.

The urologist or qualified healthcare professional performs the procedure, including patient preparation, cystoscope insertion, bladder examination, lesion destruction or resection, and post-procedure care.Proper anesthesia (local or sedation) is administered as needed.

IMPORTANT 52224 (minor lesions <0.5cm), 52234 (small tumors 0.5-2.0cm), 52235 (medium tumors 2.0-5.0cm)

In simple words: The doctor uses a thin, lighted tube (cystoscope) inserted into the bladder through the urethra to examine the bladder and urethra.If there are large bladder tumors (bigger than 5 centimeters), the doctor uses electricity, freezing, or laser to destroy or remove them.

This procedure involves a cystourethroscopic examination of the urethra, prostatic urethra (in males), bladder interior, and ureteric orifices.Lesions larger than 5.0 cm are destroyed using high-intensity electric current (fulguration), intense cold (cryosurgery), or intense heat (laser surgery). The procedure may include resection of the tumor.The cystoscope is inserted through the urethra into the bladder, allowing visualization of the bladder's interior. Saline irrigation may be used to enhance visualization. Specialized instruments are passed through the cystoscope to perform the destruction or resection of the lesion(s).

Example 1: A 65-year-old male presents with gross hematuria and a palpable bladder mass. Cystourethroscopy reveals a large, sessile bladder tumor (6cm) in the dome of the bladder. The tumor is fulgurated using electrocautery., A 72-year-old female presents with recurrent urinary tract infections and imaging shows a large bladder tumor (7cm) near the trigone.The tumor is resected using laser ablation during cystourethroscopy., A 58-year-old male with a history of bladder cancer undergoes a follow-up cystourethroscopy that reveals a large (5.5cm) recurrent tumor in the posterior bladder wall. Cryosurgery is used to destroy the tumor.

* Pre-operative diagnosis and imaging studies (e.g., CT scan, MRI, cystoscopy) showing the size and location of the bladder tumor(s).* Operative report detailing the technique used (fulguration, cryosurgery, laser surgery, or resection), the size and location of the lesion(s) treated, and any complications.* Pathology report if tissue was resected, confirming the diagnosis and describing the histologic findings.* Post-operative progress notes.

** The size of the lesion(s) is crucial for accurate code selection.This code is only applicable to lesions larger than 5.0 cm.For smaller lesions, other codes (52224, 52234, 52235) are applicable.Always ensure complete and accurate documentation to support medical necessity and accurate coding.

  • Revenue Code: P8E (ENDOSCOPY - CYSTOSCOPY)
  • RVU: This information is not available in the provided text.Consult the current year's CPT codebook or relevant payer guidelines for RVU information.
  • Global Days : The global period for this procedure is not specified in the provided data.Consult the current year's CPT codebook or relevant payer guidelines for details.
  • Payment Status: Active
  • Modifier TC rule: The TC (Technical Component) modifier may be relevant; however, consult payer-specific guidelines and the most recent CPT codebook for TC modifier application.
  • Fee Schedule : Historical fee schedule data is not provided.Consult relevant payer databases or fee schedules for historical reimbursement rates.
  • Specialties:Urology
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
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