Wiki suprapubic catheter replaced through stoma - cpt?

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jbtrueba

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What code would I use for insertion of suprapubic catheter through stoma. Documentation states; suprapubic catheter replaced, balloon inflated, 15cc's NS flushed until clear.
CPT 51705, per the CDR, states that a guidewire is used and the catheter is sutured to the skin. The documentation on the ER report I have does not state anything regarding a guidewire or suturing to the skin so I'm not sure 51705 would be the appropriate code. I am leaning more toward 51702, but I am not sure.
Thank you
 
Suprapubic catheter placement

51102 would be appropriate for suprapubic catheter placement. You might wonder about the description of "Aspiration of bladder" in this code. However, there couldn't be any other purpose for placing suprapubic catheter.
 
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The catheter that was placed was an indwelling catheter. Why would 51102 (aspiration of bladder; by needle w/insertion of suprapubic catheter) be the more appropriate code?
 
Refer to the 2007 CPT Assistant below.......you were on the right track with the 51705.

Surgery: Urinary System

Question:

Is code 51705 the correct code to report for change of a suprapubic catheter?

Answer:

Yes. Code 51705, Change of cystostomy tube; simple, may be reported to describe the removal of an existing suprapubic cystostomy tube with reinsertion of a new tube through the established cystostomy tunnel from the abdominal wall to the bladder. Code 51710, Change of cystostomy tube; complicated, may also be reported if the removal and replacement of the suprapubic tube involves a more complex encounter. Code 51102, Aspiration of bladder; with insertion of suprapubic catheter, involves performance of a stab wound on the lower abdomen (approximately 1 cm) above the pubis. A trocar suprapubic tube is inserted into the bladder. The balloon is inflated and the tube sutured into place. This code should be reported for the initial insertion of the suprapubic catheter when performed as described.
 
Suprapubic catheter removal

The non-incisional removal of a suprapubic catheter is part of the E/M code and is not reported with a CPT procedure code. However, I question when the catheter is removed (non-incisionally) and then a stitch is placed in the existing wound.

Would that just be inherent with the removal (E/M) since it is so minimal, or would it reported with a wound repair code. I am thinking it would just be part of the E/M since essentially the "wound" was surgically created. Therefore, closure of the wound would be inherent, as it is with most procedures.

Any thoughts?
 
does code 51705 need an additional code if an ultrasound was done to confirm placement?
thanks
 
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