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Urology Coding Alert

Reader Question:

53860: Check With Payer Before Billing Renessa

Published on Wed Apr 11, 2012

Question: We are thinking of providing Renessa as a treatment option for stress urinary incontinence. How should we report this service, and will we get paid?Ohio SubscriberAnswer: The CPT code for the Renessa procedure is 53860 (Transurethral, radiofrequency microremodeling 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.The catch: Many payers, including some Medicare MACs, do not pay for this service as they still consider it experimental. Best bet: 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.
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