Results 1 to 8 of 8

CPT for botox injection into bladder **help**

  1. Default CPT for botox injection into bladder **help**
    New Call-to-action
    I know that this has been brought up in the past but it's been a while and wanted to see if anyone has been getting paid. I've seen three seperate threads and I'm confused by the codes. Can anyone help and let me know what codes/Modifiers you are using. Any help would be much appreciated. THANK YOU!!!

    J0585x units



    Doctor is injecting botox into the bladder via Cysto (Intravesical botox injection)

  2. Default
    We use 53999 and compare it to 52327. We do not charge for the botox because we do not buy it.

  3. Default
    Thanks Kelly, can you clarify what you mean by "compare it to" ? Are you using both codes with a modifier or just one or the other? Thanks so much


  4. Default
    When I use an unlisted code, I provide documentation and a letter to the insurance telling them why I used an unlisted code. I give them an available CPT that my unlisted procedure is similiar to. I also base my fee for the unlisted code to the "benchmark" procedure.

  5. #5
    we use 53899 in our office and list the description... if a cysto is done with we use 52005 also
    Stacey Lindsey-Smathers, CPC, RMC

  6. Default
    Stacy, do you use any modifiers when billing both? Also, how do you come up with a fee to charge for 53899? I don't see this code on the Medicare fee schedule to give me a base price.

    Thanks so much

  7. Default

    Same question. I don't see code 53999 in the book or fee schedule??? Could you mean 53899? Also, how do you price the claim as I don't see a fee on the Medicare fee schedule.

    Thank you again so much!

  8. Default
    Yes, typo! Sorry about the confusion. Since I compare my service to 52327, I base my unlisted fee close to 52327.

Similar Threads

  1. CPT for botox injection into bladder
    By hsmith67 in forum Urology
    Replies: 10
    Last Post: 06-02-2015, 01:37 PM
  2. Botox injection into bladder
    By KFortygin in forum Urology
    Replies: 5
    Last Post: 02-05-2013, 02:50 PM
  3. Botox injection into the bladder
    By l1ttle_0ne in forum Urology
    Replies: 1
    Last Post: 11-05-2012, 12:15 PM
  4. botox injection to bladder
    By bench in forum Outpatient Facilities
    Replies: 3
    Last Post: 01-06-2010, 05:50 PM
  5. Bladder Botox injection
    By ms123 in forum Outpatient Facilities
    Replies: 2
    Last Post: 07-17-2009, 10:15 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.