Summary & Overview
CPT 52346: Cystourethroscopy with Ureteroscopy for Intrarenal Stricture
CPT code 52346 represents a combined cystourethroscopy and ureteroscopy procedure used to inspect the bladder and urethra and to access intrarenal structures for treatment of intrarenal strictures. This endoscopic urologic procedure has implications for surgical workflow, facility utilization, and procedural coding consistency across payers nationally. It is relevant where minimally invasive intrarenal interventions are performed and where accurate coding supports appropriate payment and quality tracking.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise understanding of the clinical scope of the code, typical sites of service, common billing modifiers associated with complex surgical and anesthesia scenarios, and the context necessary to interpret benchmarking and policy updates. The publication outlines how 52346 fits into urologic endoscopy service lines, common clinical indications for intrarenal stricture treatment, and operational considerations for hospitals and ambulatory surgical centers. It also summarizes areas where payers often align or differ in prior authorization and documentation expectations.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 52346 describes a combined endoscopic procedure in which the clinician performs cystourethroscopy to inspect the interior of the bladder, the urethra, the prostatic urethra, and the ureteric orifices, and then inserts a ureteroscope through the ureters to intrarenal structures to identify and treat an intrarenal stricture using one of several endoscopic methods.
Service type: Endoscopic urologic diagnostic and therapeutic procedure
Typical site of service: Hospital operating room or ambulatory surgical center (same-day procedure)
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 58-year-old male presents with recurrent flank pain, intermittent gross hematuria, and imaging showing hydronephrosis with a suspected intrarenal collecting system stricture. The urologist schedules a combined cystourethroscopy with ureteroscopy and directed intrarenal stricture treatment. In the preoperative workflow the patient undergoes history and physical, informed consent, and preoperative anesthesia evaluation. In the operating room under general or regional anesthesia, the provider performs diagnostic cystourethroscopy using a rigid or flexible cystoscope to inspect the urethra, prostatic urethra, bladder mucosa, and ureteral orifices. A ureteral access sheath and ureteroscope are passed retrograde through the ureter into the renal pelvis and calyces to visualize the intrarenal stricture. Treatment options performed during the same session may include balloon dilation, cold knife incision, endoscopic incision with laser (e.g., holmium), or placement of a ureteral stent. Recovery includes short PACU observation, discharge with analgesia and stent care instructions when applicable, and follow-up imaging or cystoscopy to confirm resolution of the stricture and stent removal if placed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Provider performed the procedure (default) | Use for standard, uncomplicated performance of the full procedure by the reporting surgeon when no other modifier applies |