Urology Coding Alert
Does Global Period Affect SP Tube Change?
Texas Subscriber
Answer: When your urologist changes a suprapubic (SP) tube within the global period of a cystostomy, Medicare and private payers may consider the surgery as part of the original procedure. In this case, the SP tube change occurs within the 90-day global period of an open cystostomy that you reported using CPT 51040 (Cystostomy, cystotomy with drainage).
Report either 51705 (Change of cystostomy tube; simple) or 51710 (... complicated) with modifier 58 (Staged or related procedure or service by the same physician during the postoperative period) for an SP tube change that takes place in the office during the global period of the surgery.
Good idea: You may want to suggest that, in situations like this, your doctor include a note in his operative report stating that, as part of the surgical procedure, he may perform a tube change during the global period.
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