Wiki DME Supplies

[KaylaRieken]

If a patient comes in for a catheter exchange (51702), are we able to bill for the supplies (catheter, leg bag)? Or would they be bundled into the procedure? We do have a DME number so I understand that we are allowed to bill for extra supplies given to the patient.

 

[Bernadette10]

I got an answer from a clinic I just started working for on this topic, that the catheter supplies are included in the procedure CPT code in the office setting, POS 11, and that they're not separately billed. I'm surprised there isn't more info available on this subject. The only thing I was able to find is this article about billing in the hospital/facility setting and how the RVU for non-facility is higher because it includes the office expenses.

https://info.prsnetwork.com/how-to-bill-for-catheter-placement-in-the-hospital-setting/
When you’re paid for the procedure in the office, you are paid a higher fee than when you perform the same procedure at the hospital. Look up 51702 in AUACodingToday, scroll down to “fee schedule,” and look at “facility fee.” The national payment is $27. The non-facility fee, or office fee, is $65.88. This additional payment is for the catheter and the office expenses. In short, it is not only OK to report 51702 in the hospital, it is in fact the correct way to report the simple insertion of a Foley catheter in the hospital.