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Keep Reimbursements Flowing With These

Bladder Cath Tips


By Susan Dooley

Urinary catheterization procedures are common in numerous settings, from emergency departments to
provider offices. But coding for catheterization insertions and removals can be tricky. Check out
these tips to make sure your bladder cath claims float straight to full reimbursement.

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com

Choose a Code for Catheter Insertion


When your provider performs a catheter insertion, you report the procedure with one of these three
codes.

51701, Insertion of non-indwelling bladder catheter (e.g., straight catheterization for residual
urine)

Non-indwelling means the catheter isnt designed to stay in the bladder for an extended period of time.
In this procedure, a non-indwelling catheter is placed temporarily and removed, usually on the same
day. Report 51701 when a non-indwelling bladder catheter is inserted, then immediately removed after
urine is obtained for diagnosis purposes (but not for Medicare) or when a patient has a postvoiding
residual of urine in the bladder.

51702, Insertion of temporary indwelling bladder catheter; simple (e.g., Foley)

A Foley catheter is the most commonly used bladder catheter. This thin tube is passed into the bladder
via the urethra and left indwelling in the bladder for a period of time to drain urine. A patient who
presents with acute urinary retention might require insertion of an indwelling Foley; the patient would
then go home with the Foley in place.

51703, Insertion of temporary indwelling bladder catheter; complicated (e.g., altered anatomy,
fractured catheter/balloon)

Notice the use in 51703 of the term complicated. As always, coders should look to the providers
documentation for clues that the procedure was complicated. For example, notice whether the provider
had to pass the catheter over a guidewire or use a Coude catheter instead of a straight catheter, or a
Heyman dilator or a Councill-tipped catheter. Or, if the catheter itself malfunctions, perhaps with a
balloon that wont deflate because its valve doesnt work, the doctor may have to break the valve to get
the fluid out.

If Another Doc Had Trouble and You Didnt


What if your provider is a urologist or just skilled at catheter insertion and is called to insert a
catheter when another provider was unable to complete the procedure? If your provider also had
difficulty inserting the catheter, you can bill 51703. According to the experts at the American Urological
Association, the determination of difficulty is up to the physician who successfully passes the catheter.
Use this code for situations where altered anatomy or a defect in the catheter itself makes the insertion
difficult.

Coding for Catheter Removal


CPT provides no special code for catheter removal. However, when your provider removes a catheter
during an office visit, you may be able to report an appropriate E/M code, such as an established patient
office visit (99211-99215, Office or other outpatient visit for the evaluation and management of an
established patient ).
The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com

How About You?


Got any cath coding tips that we missed? Let us know.

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Contact Us:
Name: Sam Nair
Title: Associate Director
Email: shyamn@codinginstitute.com
Direct: 704 303 8150

Desk: 866 228 9252, Ext: 4813


The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com

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