Wiki Aquablation

[julieordway]

Our office is currently considering offering aquablation surgery for BPH. Has anyone been successful at being reimbursed at Aquablation? It uses category III code, 0421T. We will be the first in the state of Oregon to offer it.

 

[TThivierge]

Hi Julie,
CPT 52601 or repeat TURP 52630 can be billed in conjunction with Aquablation . Add modifiers 58 or 78 if apply. The ICD10 PCS inpt. code is XV508A4. Possible dx codes are N40 (add dx R35 blocks if apply),N50.8, E29 and C61 but ensure do prior authorization for most commercial payers. Medicare does not cover it. Transurethral resection of the prostate (TURP) and open simple prostatectomy (OSP) are the standard surgical treatments for LUTS/BPH and are highly effective and provide improved outcomes in urinary functions. However, neither TURP nor OSP are without considerable perioperative complication and morbidity. Recently, new minimally invasive surgeries have emerged as alternatives for the resection of the prostate to manage LUTS in men with BPH. One such surgery is transurethral waterjet ablation which is minimally invasive; water based surgical therapy that combines image guidance and robotics to remove prostatic tissue. The system works by pumping high pressure saline (500 to 8000 pounds per square inch [PSI]) through a probe nozzle to cut and dissect tissue at predetermined system parameters

I would add history codes of Z85.45 or Z87.430 or Z19.2 if apply related to past prostate or kidney or urinary problems.
I hope helped you. Good luck!
Lady T