Correct reporting of Urinary Cathter (Foley, Suprapubic Catheter)

Topic Include in this post :

What is Suprapubic Catheter

What is Foley Catheter

Suprapubic Vs Foley Catheter

Difference between Intermittent Catheter or Non-indwelling and Indwelling Catheter

How to report Foley Catheter : CPT Code

How to report Suprapubic Cathter : CPT Code

What is Suprapubic catheter ?

Suprapubic Catheter as name suggests, the catheter that is inserted above pubic bone, the purpose of this catheter is to drain the urine. It is inserted into the bladder through the abdominal wall through the incision.

This type of catheter is used as the patient had any pelvic surgery, urethral injury or patient has urinary problem like Urinary retention , Urinary tract obstruction etc. This catheter is used when patient has to use the urinary catheter for the long time, foley catheter is not preferred.

What is Foley Catheter ?

Foley catheter is the catheter that is inserted into bladder through the urethra . This drain the urine into drainage bag.

Suprapubic Vs Foley Catheter

The purpose of both catheter is to drain urine but one inserted by making incision and other is inserted through urethra.

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Difference between Intermittent Catheter or Non-indwelling and Indwelling Catheter

Intermittent meaning not continuous- So, this type of catheter is inserted and removed several time to empty bladder.

Indwelling means remaining inside the body for longer time so, this type of catheter is placed in the bladder for a longer period as compared to intermittent to drain the urine. So, foley catheter is indwelling catheter. 

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CPT for insertion of non-indwelling bladder Catheter

51701 :Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)

Describes the insertion of a nondwelling bladder catheter used for intermittent catheterization or catheterization to obtain postvoid residual, and then it is removed.

Urinary Catheter

How to report Foley Catheter : CPT Code

Insertion of Foley Catheter and replacement of Foley Catheter:

Same code is used for insertion or replacement

51702: Insertion of temporary indwelling bladder catheter; simple (eg, Foley) 

51703: Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon

Codes 51702 and 51703 describe the insertion of a temporary indwelling bladder catheter that remains in place for a period of time. 

Removal of foley Catheter 

1.By Incision-53899 

2.By Endoscopic- 52310 (Simple), 52315 (Complicated) 

3.By Other/Unspecified- There is no any CPT code for non-incisional removal of cathter, These service are included in the Evaluation and Management by the physicician for that day.

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How to report Suprapubic Cathter : CPT Code

Insertion of Suprapubic Catheter 

1.Percutaneous/Closed- 51102 

2.Open -51040 

Here, the term cystotomy tube is used for Suprapubic catheter 

Removal of Suprapubic Catheter CPT 

1.By Incision-53899 

2.By Endoscopic- 52310 (Simple) 52315 (Complicated) 

3.By Other/Unspecified- There is no any CPT code for non-incisional removal of cathter.

These service are included in the Evaluation and Management by the physicician for that day. Do not report 51701-51702 when catheter insertion is an inclusive component of another procedure."

Replacement 

51705: Change of Suprapubic Catheter, Simple 

51710: Change of Suprapubic Catheter, complicated 

Note : 51701 and 51702 not bundled with bladder scan.

Scenario 1

A female patient presents with a complaint that she does not feel she completely empties her bladder when voiding.The provider inserts a straight (non-indwelling) catheter to drain the bladder and measure the residual urine volume. The catheter is removed immediately after drainage.

Answer : 51701 is reported for non-indwelling (straight) catheter insertion used for bladder drainage or post-void residual measurement.

Scenario 2

A patient presents in acute urinary retention.

The provider inserts a temporary indwelling Foley catheter, and the patient leaves the office with the catheter in place.

Answer :51702 is reported for temporary indwelling bladder catheter insertion (e.g., Foley catheter).