Primary Care Coding Alert

Question: A charge ticket indicates the FP performed an "in & out cath." Diagnosis is dysuria (788.1.) In the 51700-51703 range, which CPT code should I use? Montana Subscriber Answer: You should submit 51701 (Insertion of non-indwelling bladder catheter [e.g., straight catheterization for residual urine]). The FP in this procedure inserts a non-indwelling catheter to obtain residual urine. An "in & out cath" suggests putting the catheter in and immediately removing it, which falls under non-indwelling catheter. Procedure documentation might also describe whether the physician placed the catheter with or without difficulty, the measurement of return from the catheter, and if she removed the catheter with or without complications. If the physician inserts a catheter into a patient's bladder and allows the device to remain in place, you would use 51702 (Insertion of temporary indwelling bladder catheter; simple [e.g., Foley]) or 51703 (... complicated [e.g., altered anatomy, fractured catheter/balloon]). Submit [...]