# Urology-Need assistance



## lisam (Aug 29, 2008)

Need assistance with a Operative report for Urology.

The procedure states a cystoscopy with a botox A injection (200 units).

Notes from the report state that the ureteral orifices were identified.  Injections were begun at the trigone followed by the floor and up to the sidewall degree.

Is there a code to use with the cyctoscopy and botox?

Should I use the 52000 with a unlisted code of 53899?

Thank you,

Lisa


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## dmaec (Aug 29, 2008)

not my area of expertise but I'd code the cysto - 52000 along with the ICD-9 procedure code (volume 3) for the injection of the botox. (I'm assuming someone enters all the Jcodes used) 
I don't believe 53899 should be used for the injection of the botox, it's "just" an injection - however it's delivered will determine your ICD-9 procedure code.
_{that's my opinion on the posted matter}_

 I'm not finding an ICD-9 procedure code (yet) - but I still say, 53899 would not be appropriate....


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## abozeman (Sep 9, 2008)

Hi Lisa,

I'm not sure if this will help but you might want to check CMS for an LCD.  I'm in North Carolina and the LCD lists CPT codes for the injection...for example with a dx of 596.54 we use CPT 64640.  You can only bill the code once no matter how many injections but the reimbusement in NC is around $200.00.


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## JBJ (Sep 16, 2008)

*Botox*

Actually, the AUA instructs one to use code 53899.


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## zaidaaquino (Sep 16, 2008)

There is no specific CPT code for injecting the bladder with Botox, so you would use *53899*.  I don't know if you have acces to the Urology Coder's Pink Sheet, but they have had several issues where they address the injection of Botox.  (e.g., June 2007, July 2007 issues) Since you are using type A Botox, are you billing J0585?  Also, the diagnosis used can determine whether or not you will receive payment for 53899.  

Zaida, CPC
Northern Virginia Urology


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