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Topic: Learn to use all the catheterization codes, part 1

Ambulatory Surgery Reimbursement Update, August 19, 2008

There are four catheterization codes, but many coders are familiar with how to apply only two of these codes, says Michael A. Ferragamo, MD, FACS, assistant clinical professor of urology at the State University of New York at Stony Brook’s University Hospital in Garden City, NY.

Do not use these codes together. Instead, look at the documentation to determine the appropriate single code to report, Ferragamo says. Here’s a closer look at how to properly assign three of the four catheterization codes:

• Code 51701. Use this for the insertion of a nonindwelling bladder catheter. Report this code for straight catheterization for postvoiding determination of residual urine. The reimbursement for this procedure when performed in the office setting is more than it would be if the physician performed the procedure in the ASC because, in the office, the physician supplies the catheter.
• Code 51702. Apply this for the insertion of a temporary, indwelling bladder catheter. In this case, the physician might give the patient a leg bag or drainage tube. This procedure involves the passage of a Foley catheter that the procedure will leave indwelling for a period of time. Again, payment for this procedure is higher in an office setting than in the ASC.
• Code P9612 is in the laboratory section of the CPT code book. Apply code P9612 for Medicare only when a physician puts in a catheter to get a specimen for clean urine analysis or for clean culture sensitivity, Ferragamo says. For private carriers, bill CPT code 51701 when you insert a catheter for clean urine analysis.

Editor’s note: Read about the fourth catheterization code in next week’s issue of ASRU. For more information on catheter coding, see the August issue of Ambulatory Surgery Coding and Reimbursement Insider.

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