Urology Coding Alert

Question: How should I report a potassium sensitivity test ?


North Carolina Subscriber

Answer: For the installation of the potassium chloride, you should report 51700 (Bladder irrigation, simple, lavage and/or installation). During this test, the urologist instills potassium chloride directly into the patient's bladder.

For the potassium chloride solution, you should report J3480 (Injection, potassium chloride, per 2 meq). The J code represents every 2 meq of potassium chloride, and a urologist typically instills about 20 meq, so be sure to reflect the number of units (10) on your claim.

If a patient has a reaction and the physician performs salvage treatment with heparin instillation into the bladder, you should also report J1644 (Injection, heparin sodium, per 1,000 units), again reflecting the number of units used in box 24G of the 1500 form.

Don't miss: Often a urologist performs a urinalysis as well. You can report this separately using the appropriate code for the test (81000-81099). If the physician also performs a separately identifiable E/M service, you can report the E/M service code as well as 51700 and the J codes.

Remember to append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the E/M code to indicate that the E/M service is separate from the potassium chloride installation service.

Urologists perform this test to determine whether a patient might have interstitial cystitis (595.1, Chronic interstitial cystitis).

Additional diagnosis codes you may report include the symptoms of interstitial cystitis that the patient presents with. Symptoms of interstitial cystitis often include bladder pain (788.9), urinary frequency (788.41), and urgency of urination (788.63), in addition to others.