Urology Coding Alert
Botox for Bladder Spasms Leads to a Specific CPT® Code
Question: My urologist is injecting botulinum toxin (type A) to alleviate bladder spasms. How should we code this procedure? Pennsylvania Subscriber Answer: Bill CPT® code 52287 (Cystourethroscopy with injection(s) for chemo-denervation of the bladder). Use this one code for any number (multiple) of Botox bladder wall injections. This code has a zero (0) day global so all post-injection services can be billed and be paid. Important: Code 52287 replaces previously billed codes 53899 (Unlisted procedure, urinary system) and 64640 (Destruction by neurolytic agent; other peripheral nerve or branch). When the injections are provided in an office setting, report the drug itself with HCPCS code J0585 (Injection, onabotulinumtoxinA, 1 unit) administering a total dose of 100 to 300 units. This drug has recently been approved by the FDA for N32.81 (Overactive bladder) and N31.1 (Neurogenic bladder. However, some payers may not reimburse for this drug due to its possible off-label use. You might want to ask the patient to sign an advance beneficiary notice (ABN) accepting payment responsibility so you can bill the patient for the treatment.
Related Articles
Urology Coding Alert
- Reimbursement:
Worried You Won't Get Paid for Sperm Aspiration? Don't Give Up
Other options can help fill the money gap. Urologists often perform sperm aspiration as part [...] - Diagnosis Focus:
Do You Know the Best Diagnoses for Azoospermia?
Keep these options in mind for success. Azoospermia is the absence of any sperm in [...] - E/M Focus:
Take Advantage of When Time Plays in Your Favor
Choose your E/M coding approach wisely. Many physicians are most comfortable coding their E/M services [...] - You Be the Coder:
Coding Prostate Biopsies for Medicare Claims
Question: Medicare denied our claim for prostate biopsies; we billed 14 units of 88305 since [...] - Reader Question:
Botox for Bladder Spasms Leads to a Specific CPT® Code
Question: My urologist is injecting botulinum toxin (type A) to alleviate bladder spasms. How should [...] - Reader Question:
Remember Edits Prohibit Reporting 54600 and 54620 Together
Question: The patient underwent a surgical exploration and a detorsion of right testis along with [...] - Reader Question:
Choose N32.89 for Bladder Erythema
Question: What is the best diagnosis code to report for bladder erythema? I’m deliberating between [...] - Reader Question:
Assign T83.192A for Calcified Ureteral Stent Diagnosis
Question: Can we report 50590 for freeing a calcified ureteral stent? If so, what diagnosis [...] - Reader Question:
File 50548 for Laparoscopic Total Nephroureterectomy
Question: How should I code for a hand-assisted laparoscopic total nephroureterectomy with open distal ureterectomy [...] - Reader Question:
Complexity of Procedure Distinguishes 51860 from 51865
Question: A patient underwent laparoscopic sigmoid resection by the general surgeon. Our urologist was called [...]
