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”?

RCI Subscriber

Answer: When your urologist mentions the use of a Texas catheter in their documentation, it is appropriate to report the code A4349 (Male external catheter, with or without adhesive, disposable, each) instead of the commonly used code for indwelling catheters, A4338 (Indwelling catheter; Foley-type, 2-way latex with coating (Teflon, silicone, silicone elastomer, or hydrophilic, etc.), each). It’s important to note that a Texas catheter, also known as a condom catheter, is an external catheter specifically designed for men. On the other hand, an indwelling catheter is inserted by the provider into the bladder through the urethra and secured in place with a small balloon. In some cases, your urologist may use the term Foley catheter when referring to indwelling catheters.

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).

Lindsey Bush, BA, MA, CPC, Development Editor, AAPC