Need your expertise!
Patient came in for removal of encrusted suprapubic catheter. First a cysto was done and prior urethra perforation was observed nicely healed. tip of catheter was observed half way in and halfway our of the bladder. Cystoscope was removed.
Then we took out the sutures from around the subrapubic tube. We tried to pull gently but it wouldn't go, it was stuck down by encrustation at which point, we were able to dissect the tube through the wall of the suprapubic site with scissors and then we were eventually able to remove the tube which was intact. Cysto was performed again to to visualize the area where the catheter had been. A little oozing was seen that stopped w/in 30 seconds. We irrigated the cystocope and looked once more and there was no active bleeding.
How would you code this case? Is the cyto(s) separately reportable? What would be the procedure for the removal of the tube. I am getting an unlisted (53899) if i go the removal route, and 51880 if I go the closure route. Also, the lay descriptions don't tell me if they cysto is separately reportable, particularly in this case.
Please help!
Thanks,
Isela
Patient came in for removal of encrusted suprapubic catheter. First a cysto was done and prior urethra perforation was observed nicely healed. tip of catheter was observed half way in and halfway our of the bladder. Cystoscope was removed.
Then we took out the sutures from around the subrapubic tube. We tried to pull gently but it wouldn't go, it was stuck down by encrustation at which point, we were able to dissect the tube through the wall of the suprapubic site with scissors and then we were eventually able to remove the tube which was intact. Cysto was performed again to to visualize the area where the catheter had been. A little oozing was seen that stopped w/in 30 seconds. We irrigated the cystocope and looked once more and there was no active bleeding.
How would you code this case? Is the cyto(s) separately reportable? What would be the procedure for the removal of the tube. I am getting an unlisted (53899) if i go the removal route, and 51880 if I go the closure route. Also, the lay descriptions don't tell me if they cysto is separately reportable, particularly in this case.
Please help!
Thanks,
Isela