Urology Coding Alert

Question: What is the correct code to use for a routine exchange (removal of old, insertion of new) of a suprapubic Foley catheter? The code descriptions for 51702 and 51703 specifically mention "bladder" catheter. Although the CPT manual description of 51705 speaks about suprapubic catheter insertion, it specifically talks about a sutured catheter rather than a Foley catheter. Which one should we be using?


Texas Subscriber

Answer: When your urologist changes a suprapubic tube, you should code the procedure using either 51705 (Change of cystostomy tube; simple) or 51710 (Change of cystostomy tube; complicated). Nothing in the CPT code descriptor indicates a sutured catheter. Also, the kind of tube the urologist uses doesn't affect your coding choice. For example, the physician could use a Foley catheter, a Malecot catheter, or a straight Robinson catheter, and you would still report 51705 or 51710.

Report 51710 if the urologist indicates a complicated tube change. For example, if the urologist must either dilate the tract before inserting the tube or pass a wire and pass the catheter over the guide wire, use 51710.

Be sure you use 51702 (Insertion of temporary indwelling bladder catheter; simple) and 51703 (... complicated [e.g., altered anatomy, fractured catheter/ balloon]) to report any kind of indwelling urethral catheter.