CCI 18.0: Avoid Catheterization Coding With Still More Procedures

And more, you'll find 51597 bundles several procedures now as well.

Every year at this time you're confronted with new and revised codes you are required to learn and just when you think you have the 2012 coding updates aced, the Correct Coding Initiative (CCI) comes along and throws coding restrictions at you.

The CCI came up with the version 18.0 at the end of 2011, with 15,530 new active pairs and 6,197 code pair deletions.

2012 Medical Coding Update: A lot of the novel code pair additions involve new 2012 CPT codes that were introduced on Jan. 1, with CCI now denying payment in case you report certain procedures together. For example, you'll find skin repair 2012 CPT codes 12001-12021 bundled into new skin substitute grafting codes 15271-15278, but in most cases, a modifier can separate the edit.

Good news: There are not too many edits to learn and apply to your urology coding, although this is the first round of bundling for 2012. Here are the ones you essentially need to know.

Add Urethral Catheterization Bundles to Your CCI Lists

Thanks to CCI 18.0, you'll find the following listed urethral catheterizations 2012 CPT codes bundled with column one codes 29582-29584 (Application of multi-layer compression system ...):

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

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

51703 – (… complicated (eg, altered anatomy, fractured catheter/balloon)).

Consequently, as with so many other procedures, catheterization of the urinary bladder at the same time as a primary procedure must not start an additional charge.

Silver lining: These edits have a modifier indicator of "1." That means you can sidestep the edit with a modifier under definite clinical circumstances.

But remember: You cannot just add a modifier (such as 59, Distinct procedural service) any time you wish to separate a bundle like this -- you have to validate it with the physician's documentation.

Watch These Urogynecology Edits

In case your physician implants a biological implant, for instance an acellular dermal matrix, you won't be able to report the new add on code +15777 (Implantation of biologic implant [e.g., acellular dermal matrix] for soft tissue reinforcement [e.g., breast, trunk] [List separately in addition to code for primary procedure]) with any of the following listed 2012 CPT codes when the procedures are carried out at the same encounter:

57240 – (Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele)

57250 – (Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy)

57260 – (Combined anteroposterior colporrhaphy)

57265 – (... with enterocele repair)

57285 – (Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach.


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