Health Information Management

Report and code all packaged ED services

APCs Insider, March 4, 2005

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Report and code all packaged ED services

QUESTION: Our facility has a question concerning Foley catheters and straight catheterizations for ED patients. Should we code these services separately?

ANSWER: Your facility should absolutely code and charge all the services it provides, including those with a status indicator N.

CPT codes 51701 (Insertion of non-indwelling bladder catheter), 51702 (Insertion of temporary indwelling bladder catheter; simple), and 51703 (Insertion of temporary indwelling bladder catheter, complicated) all have N status indicators, which means they are packaged services.  However, CMS clearly states that hospitals should report incidental services. For a reference, consult the OPPS Final Rule (pages 66767, 66794) in the November 1, 2002 Federal Register.

Report these services not only for ED patients, but for observation patients and any other outpatients treated in any hospital department. Your hospital may choose to separately report the supply charge for the catheter itself or build the cost of the catheter into the procedure charge.

Note that once you charge for incidental services, these services should not, in and of themselves, cause an E/M level to move from one level to the next.

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