Thursday, November 8, 2012

Urethral Catheterization

Urethral Catheterization

51701:  Insertion of non indwelling bladder catheter

Any time a urologist passes a urethral catheter into the bladder, drains the bladder, and removes the catheter. This service pays a 2007 unadjusted Medicare standard fee of $57.42.

An example of this would be a straight catheterization to determine a post-void residual (PVR) urine volume.

 51702: Insertion of a temporary indwelling bladder catheter; simple (Foley)

 Any time a urologist places a Foley catheter and leaves it indwelling, use CPT code 51702

This service pays a 2007 unadjusted Medicare standard fee of $93.99. This seemingly high fee includes the office expenses for performing this procedure and also the cost of the provided Foley catheter.

Do not charge the patient separately for the catheter or give him a prescription to purchase a replacement catheter for your office. This would be considered double billing.

 51703:  Complicated catheter insertion or removal

 If the urologist has difficulty inserting a catheter because of an anatomic problem (such as a urethral stricture, a false passage, or a bladder neck contracture) or has difficulty removing an already indwelling catheter, use CPT code 51703

 CPT code 51703 should be used when inserting the catheter over a guide-wire, using a catheter guide, using a Council tipped catheter guide, using a Coude catheter, using several decreasing French numbered sized catheters, or when instilling lubricating jelly into the urethra-each technique used to accomplish a difficult catheter passage.

These scenarios all allow for the coding of CPT 51703. Also note that this code is used when the urologist has difficulty removing a Foley catheter and must cut the inflation limb or disrupt the catheter balloon for its removal whether or not a new catheter is placed.

This service pays an unadjusted Medicare standard fee of $158.79. Remember that the simple removal of a Foley catheter is included in an E/M service as there is no particular CPT code for simple catheter removal.