Urology Coding Alert

Question: Is there a code for a saline stress test? My doctor is checking for any bladder leakage in patients he sees for urinary incontinence. Here's how my doctor described the procedure: "Clean urethra with Betadine, insert catheter, obtain residual urine in the sterile urine cup to be sent for culture. Inflate balloon with 3 cc of sterile saline. Instill 300 cc of saline into the bladder and then remove catheter."

Missouri Subscriber

Answer: Two different codes describe this procedure: 51701 (Insertion of non-indwelling bladder catheter [e.g., straight catheterization for residual urine]) is the code for insertion of the catheter, and 51700 (Bladder irrigation, simple, lavage and/or instillation) is the code for the instillation of saline into the bladder. The National Correct Coding Initiative edits bundle these codes together, however, allowing billing for only one code.

Since 51701 is bundled into 51700 and cannot be unbundled, for this clinical scenario report only 51700 for maximum payment.