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CPT for botox injection into bladder

H

hsmith67

Guru
Messages
158
Location
St Augustine, FL
Doc is doing 15-20 injections of botulinum toxin into the tissue of the bladder. Doc is visualizing with a cystoscope, maneuvering around the bladder and injecting the botox. Anyone know of a code for this procedure?
 
botox into bladder

Hi,
Basically this falls under the category of a therapeutic, prophylactic, and diagnotic injection administered intramuscularly - 96372. If administered without direct physician supervision then it should be billed as 99211.
 
???

Maryann,
Thanks for reply. The doc is doing the injection through the cystoscope. There are many codes in the 52000-52402 range that involve various procedures via cystourethroscopy, but none involve (from what I can tell) a therapeutic injection into the bladder itself. Doc is doing the injection "through" the cystoscope, not visualizing with cystoscope and going with other hand and doing an IM injection via external through abdomen. I don't think I was clear and wanted to clarify. Do you still think it is a 96372? Would that be 96372 X 20 for twenty injections given during one treatment?
Thanks
p.s. this is an emerging treatment for overactive bladder and I did not find anything in Category III codes.
 
we asked this question to Dr Ferragamo and he suggested to use the 52000 and hte 64640 for the botox..
we have been billing and getting paid for them both.
 
CPT 53899 ICD-9CM 99.29 -this is coded as an unlisted procedure
J0585 Botulinum toxin type A, per unit


Covered Diagnosis- 596.54,596.59,788.30-788.33 or 625.6

Injection of Botox via Cystoscopy into Bladder Muscle Wall.
Treatment for Neurogenic Bladder and Urinary incontinence.




Karyn CPC
Urology Specialty
 
Correct!

Thank you Karyn.
That is the way I have been coding them based on guidelines from the American Urological Association
 
Bringing this up again. Karyn, how do you price out an unlisted code. My doctor wants to do this procedure but I'm unclear on what I bill it out at and what is will be paid as. How does this work? Thanks so much! Northern Cal Medicare Local 7
 
You are correct about the CPT. This thread is a few years old and since the last post 52287 was added to report this procedure on 1/1/2013.

I don't really do ICD-9 Vol. 3 coding, but would probably go with 59.72. Your thoughts on this?
 
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