Physician Coding

Draft Information For Demo Only

When using the CVAC System, report the appropriate procedure code for the service(s) performed. Please refer to the Kidney Stone Coding Hub Page for detailed billing guidance related to kidney stones.

Example: If you performed lithotripsy on a kidney stone in the pelvis of the kidney and inserted a stent it would be coded as follows:

52356

Procedures using the CVAC system that require more effort and time.

Append Modifier -22 to the procedure code

Modifier 22 is used when a procedure requires significantly more effort than is typically necessary. When performing a procedure with the CVAC System from Calyxo, you may encounter scenarios where additional time, complexity, or intensity justifies appending modifier 22.

Alternative Option

Some payers suggest reporting CPT code 53899 (crosswalked to 52001) for the additional work of placing ureter access with suction capabilities in addition to CPT 52356 or 52353. Please check with your payer.
(Do not use unlisted code if 52352 is reported for removal of non-contiguous stones.)

Additional Resources:

"Reporting use of ureter access sheath with suction component"
https://www.urologytimes.com/view/reporting-use-of-ureter-access-sheath-with-suction-component

"Can you report CPT 52352 when removing fragments of a stone lasered in the ureter?"
https://www.urologytimes.com/view/can-you-report-cpt-52352-when-removing-fragments-of-a-stone-lasered-in-the-ureter-

"Billing for nephroscopy with ureteroscopy and laser lithotripsy"
https://www.urologytimes.com/view/billing-for-nephroscopy-with-ureteroscopy-and-laser-lithotripsy

Urology Coding and Reimbursement Podcast Episode #232: "Work RVUs and Modifier 22, Unlisted Codes, Category III Codes - Navigating Payer Reporting and Administrator Discussions"
https://www.prsnetwork.com/232

"Understanding RVUs, Modifier 22, and Unlisted Codes: A Guide for Urologists"
https://www.prsnetwork.com/urologistsguide