# Contrast Injection thru Suprapubic Catheter



## Anug123 (Aug 24, 2009)

hello,


How will you code for injection procedure through the indwelling suprapubic catheter?  

Thanks
Prabhavathi


----------



## msncoder (Aug 25, 2009)

Try looking at 51600/74430


----------



## Anug123 (Aug 25, 2009)

I thought of coding 51600/74430, but the code description for 51600 states contrast is injected through the catheter inserted in the bladder.  What about injection in already placed suprapubic catheter?  Does It remains same!

Help out!


Prabhavathi


----------



## msncoder (Aug 26, 2009)

Suprapubic caths are generally placed from outside of the body into the bladder so, yes, they should be the same unless the report indicates otherwise.


----------



## dpeoples (Aug 26, 2009)

If this is a catheter check injection, you should look at codes 49424,76080. Other options are the 51600 (but this is usually not performed through a previously placed catheter), or unlisted 51999.

HTH


----------



## msncoder (Aug 26, 2009)

49424 is for a cath check of an abscess or cyst drainage tube so I would be extremely reluctant to use that with this type of procedure unless your documentation specifically stated that the suprapubic cath was placed for an abscess/cyst drainage purpose. 
The lay description for CPT 51600 states -
The physician injects a radiocontrast agent through a catheter inserted in the bladder to study the lower urinary tract. Using radiologic instruments, the physician produces an image of the bladder with x-rays (cystogram).
So I'm still leaning towards 51600 but without seeing the actual report of reason for procedure it's difficult to determine for certain.


----------



## Anug123 (Aug 26, 2009)

HI,

Here is the report..

Clinical Data : “ensure bladder closure healed”
The preliminary image of the abdomen shows a double pigtail ureteral stent on the right. There is a drainage catheter in the pelvis along with a suprapubic catheter. There is contrast material in bowel visible in the right lower quadrant, probably from prior CT.
150 mL of contrast material was instilled into the bladder through the indwelling suprapubic catheter. There is no leak of contrast identified. There is contrast material in the renal collecting system on the right at the end of the examination indicating a patent double pigtail catheter. The bladder is drained and no residual contrast material is identified in the pelvis, aside from the contrast seen in bowel on the scout film.
IMPRESSION:
1. No bladder leak identified.
2. Patent double pigtail catheter with contrast material passing upward into
the right renal collecting system during the exam.

Thanks
Prabhavathi


----------

