Bladder irrigation for Interstitial cystitis

[desireewhite185@yahoo.com]

Hello,
Has anyone had experience with billing Bladder irrigation for Interstitial cystitis? I have been entering CPT 51700 and for the irrigation solution A4321. (Medicare denies the A4321)
Should I actually be billing each drug used in the solution separately? (5ml Heparin, 20ml lidocaine, 20ml sodium bicarbonate, 2ml methyl prednisolone, 10ml bacteriostatic water) Or should I be billing for the solution at all? Ty!

 

[nielynco]

Hello,
Has anyone had experience with billing Bladder irrigation for Interstitial cystitis? I have been entering CPT 51700 and for the irrigation solution A4321. (Medicare denies the A4321)
Should I actually be billing each drug used in the solution separately? (5ml Heparin, 20ml lidocaine, 20ml sodium bicarbonate, 2ml methyl prednisolone, 10ml bacteriostatic water) Or should I be billing for the solution at all? Ty!

The CPT code covers the administration procedure itself; the instilled substances must be billed separately. Each unit billed must correspond to the dosage administered and so you use J codes for the substance that matches the dosage documented. A4321 is used for cleaning during incontinence care. For the instilled substances you must report a J code for each one. But you must know the dosage, not the amount injected to get to the correct J code. In some cases the provider is using a compounded "cocktail" that has no specific J code and in that case you would report J3490 along with the NDC number of each component. In your case with the drugs listed, it looks like the typical "cocktail" and I would code accordingly.