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Bundling procedures with catheter insertion/exchange

  1. #1
    Default Bundling procedures with catheter insertion/exchange
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    Insurance companies bundle urinary catheter insertion/exchange with cystoscopy when performed on same date of service. Codes 52000 and 51702 or 52000 and 51701 for example. Does anyone have any advice/solution? Should HCPCS codes be billed to prevent bundling issues? Should/can the patient be billed for the catheter if it is bundled with the cystoscopy?

  2. #2
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    Its a hard NCCI edit following "separate procedure" coding guidelines so there is no way around. No one will pay separately for both and patient cannot be billed for bundled services.
    CRC (2018), CPC-P-A (2016), COC-A (2016), CPC-A (2015), PAHM (2010)
    Contract/Fee Specialist - Remote

    20 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

  3. #3
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    Medical Billing
    Quote Originally Posted by CodingKing View Post
    Its a hard NCCI edit following "separate procedure" coding guidelines so there is no way around. No one will pay separately for both and patient cannot be billed for bundled services.
    Thank you for your response. I didn't think there was a way around it, but I have had many questions/complaints from providers regarding this. They feel they are losing money and want to make sure billers are doing everything possible to submit claims correctly and collect maximum reimbursement.

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