Urology Coding Alert

Reader Questions:

Medicare Codes Include Anesthesia Services

Question: I've been told that we can report the instillation of novocaine into the bladder with a PVP. The only code I can come up with is 51700, but the NCCI edits bundle this code with a PVP procedure. Can I actually report this? If so, what code should I use?


Nebraska Subscriber
Answer: You cannot separately report the instillation of novocaine into the bladder. The reason is that you are correct about the bundling of the anesthesia administration and the PVP procedure. The National Correct Coding Initiative bundles 51700 (Bladder irrigation, simple, lavage and/or instillation) into the PVP code 52648 (Contact laser vaporization with or without transurethral resection of prostate, including control of postoperative bleeding, complete).

Because this bundle has a modifier indicator of "0," you can't unbundle the codes. Private carriers that follow the NCCI edits may also bundle these codes.

In addition, Medicare includes all anesthesia services (whether they be local, topical, or a block) in the operative procedure and they are not billable services. Instillation of novocaine into the bladder falls under "topical anesthesia." Private carriers also likely include topical anesthesia in the surgical package and would not consider them a payable service. Check with your local private carriers, however, to see if they may allow you to report the anesthesia service.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Urology Coding Alert

View All