Coding for bladder catheterization via a Monti channel

What is the correct code for a bladder catheterization via a Monti channel? Would this be 51702?

Jonathan Rubenstein, MD

Catheterizing a Monti channel into the bladder may be reported by one of the following codes:

• 51701 (Insertion of nonindwelling bladder catheter [eg, straight catheterization for residual urine])

• 51702 (Insertion of temporary indwelling bladder catheter; simple [eg, Foley])

• 51703 (Complicated [eg, altered anatomy, fractured catheter/ balloon])

• 51701 (Indwelling bladder catheter is inserted and immediately removed after urine is obtained for diagnostic purposes, ie, sterile urine specimen [commercial payers only] or a postvoiding residual urine [commercial or Medicare])

Use code 51702 for the routine insertion of an indwelling bladder catheter, such as a Foley. The patient will leave the office with the catheter in place using leg bag drainage.

Mark Painter

Use code 51703 when the insertion of an indwelling bladder catheter cannot be performed easily due to altered anatomy or if an already inserted catheter cannot be removed due to a defect in the catheter itself (ie, fractured catheter/balloon). The determination of difficulty should be made by the physician who successfully passes the catheter. For example, this code is not appropriate if another health care professional cannot insert the catheter and the urologist then easily inserts it. This code should be used only for difficult insertions.

HCPCS code P9612 (catheterization for collection of specimen, single patient, all places of service) is an existing HCPCS code used for Medicare claims only when the urine specimen is obtained from a patient using a straight catheter. The specimen is then used in a urinalysis, urine culture, or sensitivity study. Do not use CPT code 51701 for a specimen obtained by catheterization for Medicare claims; this code is straight catheter for residual urine.

Private carriers may adopt Medicare policies, so please double check with your private carriers.

Send coding and reimbursement questions to Jonathan Rubenstein, MD, and Mark Painter c/o Urology Times®, at UTeditors@mjhlifesciences.com.

Questions of general interest will be chosen for publication. The information in this column is designed to be authoritative, and every effort has been made to ensure its accuracy at the time it was written. However, readers are encouraged to check with their individual carrier or private payers for updates and to confirm that this information conforms to their specific rules.