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This procedural reimbursement guide, for select Stone Management procedures, provides coding and reimbursement information for physicians and facilities. The Medicare payment amounts shown are national average payments. Actual reimbursement will vary for each provider and institution based on geographic differences in costs, hospital teaching ...
The official description of CPT code 52344 is: ‘Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision).’. This code specifically refers to the procedure of cystourethroscopy and ureteroscopy for the treatment of a ureteral stricture.
We recommend consulting your relevant manuals for appropriate coding options. The following codes are thought to be relevant to ureteroscopic stone removal (including ureteral stent insertion) and are referenced throughout this guide. CPT®. Code1. Code Description.
Each CPT code will have a specific device offset amount which will be used to calculate the TPT payment. CPT Codes and 2024 Medicare National Payment Rates for Ureteroscopy Procedures
C-Codes are tracking codes established by the Centers for Medicare & Medicaid Services (CMS) to assist Medicare in establishing future APC payment rates. C-Codes only apply to Medicare hospital outpatient claims.
This coding reference guide is intended to provide common coding and reimbursement information for cystoscopic, ureteroscopic and percutaneous stone management procedures. The Medicare rates listed below are reflective of 2024 Medicare national average reimbursement rates
report use of the Flex-XC1 single-use ureteroscope. This code was established by CMS January 1, 2023, and is eligible for transitional pass-through (TPT) payment with Medicare in the hospital outpatie. t and ASC setting when used with certain procedures. Of the stone-management procedures provided in this guide, C1747 is eligible for TPT.
