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Durasphere® EXP - Reimbursement Codes

 

DIAGNOSIS

CODE

ICD-9 code: 599.82 Intrinsic Sphincter Deficiency (ISD)

(Must appear as primary diagnosis on all claims for reimbursement.)

 

ICD-9 code: 625.6 Stress Incontinence, female

INJECTION

PROCEDURE

CPT-4 code: 51715 Endoscopic injection of implant material into the sub-mucosal tissue of the urethra and/or bladder neck.

 

CPT CODE

HOSPITAL

OUTPATIENT

AMBULATORY SURGERY

CENTER (ASC)

OFFICE

BASED

51715 - Endoscopic

Injection

      Physician Fee

      Facility Fee

 

$183

$1,784

 

$183

$510

 

$277

NA

L8606 - Synthetic implant urinary 1ml

 

NA*

 

$184**

 

$184**

* HCPCS code C2631- "Repair device, urinary incontinence, without sling" should also be reported by the hospital.  This is for Medicare information gathering purposes only. 

** If using a 3ml syringe, it should be billed as three (3) 1ml syringes.

 

OTHER

DIAGNOSTIC

PROCEDURES

Cystometrogram (CMG)

 

       Simple

CPT-4 code: 51725

       Complex

CPT-4 code: 51726

 

Electromyography Studies (EMG)

 

 

EMG of anal or urethral sphincter

 

 

       Non-needle

CPT-4 code: 51784

 

       Needle

CPT-4 code: 51785

 

Voiding Pressure Studies (VP)

 

 

       Bladder

CPT-4 code: 51795

 

       Intra-abdominal

CPT-4 code: 51797

 

Cystoscopy

CPT-4 code: 52000

 

Post-void Residual

 

 

      Catheterization, Urethra, Simple

CPT-4 code: 53670

 

      Bladder Scan

HCPCS code: G0050

Disclaimer: Medicare Reimbursement rates listed above are based on average rates and were obtained from third-party sources.  Carbon Medical Technologies makes no express or implied warranty or guarantee that these codes will be covered or that the provider will receive the reimbursement rates set forth herein.

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