Urology Coding Alert

Urology coders glide through the latest Correct Coding Initiative edits and into the new year with only a handful of new bundles to reckon with. Here's the rundown. The CCI Edits effective Jan. 1 through March 31 managed to put 2003's new CPT Codes into proper context, clarifying what they include and are included in from day one of their incorporation. The latest set of edits has also bundled a nerve block code (64416) into the overwhelming majority of urinary system surgical procedures. First, CCI 9.0 guarantees urology practices won't be receiving additional reimbursement for catheterizations by bundling two of the three new catheter codes, CPT 51701 (Insertion of non-indwelling bladder catheter [e.g., straight catheterization for residual urine]) and 51702 (Insertion of temporary indwelling bladder catheter; simple [e.g., Foley]), into all procedures in which the comparable 2002 catheter code, 53670, was included. The new catheter bundles corroborate the CPT guidelines for 51701 and 51702 that state, "Codes 51701-51702 are reported only when performed independently. Do not report 51701-51702 when catheter insertion is an inclusive component of another procedure."

CCI 9.0 also clarifies the procedures bundled into the new catheter codes 51701, 51702 and 51703 ( complicated [e.g., altered anatomy, fractured catheter/balloon]): 36000* Introduction of needle or intracatheter, vein 36410* Venipuncture, child over age 3 years or adult, necessitating physician's skill (separate procedure), for diagnostic or therapeutic purposes. Not to be used for routine venipuncture 37202 Transcatheter therapy, infusion other than for thrombolysis, any type (e.g., spasmolytic, vasocon-strictive) 53080 Drainage of perineal urinary extrava-sation; uncomplicated (separate procedure) 62318 Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; cervical or thoracic 62319 lumbar, sacral (caudal) Nerve block codes 64415, 64417, 64450, 64470 and 64475 +69990 Microsurgical techniques, requiring use of operating microscope (list separately in addition to code for primary procedure) 90780 Intravenous infusion for therapy/diagnosis, administered by physician or under direct supervision of physician; up to one hour P9612 Catheterization for collection of specimen, single patient, all places of service. The most recent edits manage to inform coders of the procedures bundled into all of the new codes in a surprisingly timely manner. 64416 (Injection, anesthetic agent; brachial plexus, continuous infusion by catheter [including catheter placement] including daily management for anesthetic agent administration), a new code in 2003, is now included in the large majority of urology procedures. In other edits, two urology-related mutually exclusive code pairs have been added to the list of codes that are not to be billed together: G0002 and 51701, and G0002 and 51702.