Urology Coding Alert

Question: What is the code for a Botox injection into the bladder for incontinence? Maryland Subscriber Answer: Before using Botox, it is imperative that you verify coverage from your carriers and get prior authorization and maybe even some tips on how they would like your claim to look. Injecting Botox as a temporary treatment for urinary incontinence has not been around long enough for many carriers to cover the service, let alone have a policy on how to code it. But if you are lucky enough to have a carrier that will authorize the Botox injection for the patient, you will probably need to code according to one of the following methods.

Method 1: Use 52000 for the cystoscopy, 51700*-51 (Bladder irrigation ... Multiple procedures) for the injections into the bladder wall, J0585 for 99 units of Botox, and J0585-59 (Distinct procedural service) for the last unit of Botox (the units column will only permit two-digit numbers).


Method 2: Use unlisted-procedure code 53899 for the cystoscopy and injection therapy, J0585 for 99 units of Botox, and J0585-59 for the last unit of Botox. If you use the unlisted-procedure code, remember to submit a paper claim with very detailed documentation of the service rendered. Answers to You Be the Coder and Reader Questions contributed by Wendy Dicus, CPC, coding supervisor for Alaska Billing Services in Anchorage; Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook; and Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 19-urologist practice in Indianapolis.