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Thread: CPT for botox injection into bladder **help**

  1. #1

    Default CPT for botox injection into bladder **help**

    AAPC: Back to School
    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. #2


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

  3. #3


    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. #4


    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
    Join Date
    Apr 2007


    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. #6


    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. #7



    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. #8


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

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