Reimbursement Advisor

Hydrodistention, cystoscopy: Why and what code?

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Q Can you enlighten me on therapeutic hydrodistention of the bladder: What is this for? What code would I use? A diagnostic cystoscopy was also performed.

A Cystoscopy with hydrodistention, usually done as an outpatient procedure under regional or general anesthesia, is used to diagnose and sometimes treat interstitial cystitis.

During cystoscopy, the inside of the bladder is examined. Then the bladder is filled to a high pressure with fluid (hydrodistended). This causes the bladder wall to stretch, allowing the physician to inspect for changes typical of interstitial cystitis. Hydrodistention may reduce pain and discomfort in some interstitial cystitis patients, and thus may be therapeutic as well as diagnostic.

For this procedure, code either 52260 (Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction [spinal] anesthesia) or 52265 (…with local anesthesia). Be sure to verify the anesthesia type before billing for this service.

Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

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