Outpatient Facility Coding Alert
Remember Many Payers Consider Renessa Experimental
PDF
Question: Mrs. Smith had Renessa as a treatment option for stress urinary incontinence. How should we report this service, and shall we be paid?
Kentucky Subscriber
Answer: The CPT® code for the Renessa procedure is 53860 (Transurethral, radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence). In 2011, CPT® deleted Category III code 0193T, replacing it with the new Category I code 53860 with the same descriptor.
Red flag: Many payers, including some Medicare MACs, do not pay for this service as they still consider it experimental.
Best option: Check with the payer you will be billing before performing this procedure. Find out if they cover it at all, and if they do, what they will reimburse for a Renessa procedure.
Outpatient Facility Coding Alert
- Modifier Review:
Brace Yourself with Modifier 59 for Distinct Procedural Services
Refer to Medicare’s Correct Coding Initiative (CCI) before using Modifier 59 Modifier 59 (Distinct procedural [...] - ICD-10 Transition:
Don't Fall for the Myth That ICD-10 Won't Affect Outpatient Services
Be equipped with the plan of action to embrace the new system The notion that [...] - Reader Question:
Count the Number of Muscles and Not Injections
Question: The physician administered trigger point injections to fingers 2-5 on both the patient’s hands. He [...] - Reader Question:
Biopsy Is Bundled With Excision Code 31541
Question: During an operative session, the surgeon performed two procedures: Direct laryngoscopy with microsuspension laryngoscopy and [...] - Reader Question:
Code 14040 Suffices for Lesion Removal and Tissue Transfer
Question: The dermatologist performed an adjacent tissue transfer. Should I also code for the associated lesion [...] - Reader Question:
Keep the Global Period in Mind When Using 66821 For the Same Eye
Question: The ophthalmologist performed a YAG laser capsulotomy. The patient on a return visit, after 6 [...] - Reader Question:
Remember Many Payers Consider Renessa Experimental
Question: Mrs. Smith had Renessa as a treatment option for stress urinary incontinence. How should we [...] - Reader Question:
Check Documentation for Any Additional Post Operative Services
Question: The pain management specialist inserted a catheter for a continuous femoral nerve block for acute [...] - You Be the Coder:
Learn the Strategy for Coding Skin Lesion
Question: Mr. Johns was referred by the family physician to one of our physicians for a [...]