Medicare Benefits Schedule - Note TN.8.158

The co-claiming restrictions for 36842 with items 36812, 36827 to 36863, 37203 and 37206, prevent the restricted items from being co-claimed as part of the same procedure, but do not prevent the restricted items from being claimed as separate procedures on the same day.

Related Items: 36842 37203 37206

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Multiple Operation Rule

Cystoscopy, with lavage of blood clots from bladder, including any associated cautery of prostate or bladder, other than a service associated with a service to which any of items 36812, 36827 to 36863, 37203, 37206, 37230 and 37233 apply

(Anaes.)

Fee: $343.75 Benefit: 75% = $257.85

(See para TN.8.158 of explanatory notes to this Category)

Multiple Operation Rule

Prostatectomy, transurethral resection using cautery, with or without cystoscopy and with or without urethroscopy, and including services to which item 36854, 37201, 37202, 37207, 37208, 37245, 37303, 37321 or 37324 applies

(Anaes.)

Fee: $1,101.70 Benefit: 75% = $826.30

(See para TN.8.158 of explanatory notes to this Category)

Multiple Operation Rule

Prostatectomy, endoscopic, using diathermy or other ablative techniques:

(a) with or without cystoscopy and with or without urethroscopy; and

(b) including services to which one or more of items 36854, 37303, 37321 and 37324 apply;

continuation, within 10 days, of treatment of benign prostatic hyperplasia that had to be discontinued for medical reasons

(Anaes.)

Fee: $590.05 Benefit: 75% = $442.55

(See para TN.8.158 of explanatory notes to this Category)