Urology Coding Alert

Question: I’m confused about the types of urinary catheters and how they are coded in HCPCS Level II. I’ve seen indwelling catheters documented and have coded them using A4338, but is that the code I use if there’s an order for and placement of a “Texas catheter”?

Montana Subscriber

Answer: When your urologist documents they placed a Texas catheter, report A4349 (Male external catheter, with or without adhesive, disposable, each) rather than the commonly used indwelling catheter code, A4338 (Indwelling catheter; Foley-type, 2-way latex with coating (Teflon, silicone, silicone elastomer, or hydrophilic, etc.), each). A Texas catheter, also referred to as a condom catheter, is an external catheter for men, whereas a provider inserts an indwelling catheter into the bladder through the urethra and inflates a small balloon to secure it in place. Your urologist may document indwelling catheters using the term Foley catheter.

You may also see documentation about intermittent catheters, which providers often refer to as “straight catheters.” These are temporary catheters urologists insert for things like obtaining a sterile urine sample or draining the bladder when a patient is unable to void on their own. Report this type using A4351 (Intermittent urinary catheter; straight tip, with or without coating (Teflon, silicone, silicone elastomer, or hydrophilic, etc.), each).