Outpatient Facility Coding Alert
Remember Many Payers Consider Renessa Experimental
Question: Mrs. Smith had Renessa as a treatment option for stress urinary incontinence. How should we report this service, and shall we be paid?
Kentucky Subscriber
Answer: The CPT® code for the Renessa procedure is 53860 (Transurethral, radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence). In 2011, CPT® deleted Category III code 0193T, replacing it with the new Category I code 53860 with the same descriptor.
Red flag: Many payers, including some Medicare MACs, do not pay for this service as they still consider it experimental.
Best option: Check with the payer you will be billing before performing this procedure. Find out if they cover it at all, and if they do, what they will reimburse for a Renessa procedure.
Outpatient Facility Coding Alert
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