Urology Coding Alert

Question: Our doctor inserts a catheter to collect "clean catch" urine specimens. What's the code for taking urinalysis by catheter?

California Subscriber

Answer: The correct code to describe obtaining, by catheter, a urine "specimen" for a "clean" urinalysis or culture and sensitivity depends on the insurance carrier involved. For Medicare, you should report the "catheterization for a specimen" with HCPCS code P9612 (Catheterization for collection of specimen, single patient, all places of service).

For commercial, HMO or private carriers, you should report 51701 (Insertion of non-indwelling bladder catheter), because most carriers do not recognize P9612. Expect substantially higher reimbursement for 51701 than for P9612.

- Answers to Reader Questions and You Be the Coder contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook, New York; and Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 19-urologist practice in Indianapolis.