Our hospital coders are questioning the NCCI edit that appears when using code 96372 with 51702 and also code 93005 with a 51701. We are not sure why an injection code would bump up against a Foley or why an EKG would bump up against a straight cath. Any
September 14, 2009
The current edit indicates that code 96372 (subcutaneous or intramuscular injection) is included in code 51702 (insertion of Foley catheter). This edit may be in place so the provider does not bill for an injection to ease the patient's anxiety (which is highly unlikely). However, if the injection was for a substance not related to the Foley catheter insertion, it would be appropriate to assign modifier 59 to code 96372.
In version 15.1, we do not see that there is an edit between codes 93005 and 51701. However, Chapter 7 of the NCCI Policy Manual states the following: 1. Insertion of a urinary bladder catheter is a component of the global surgical package. Urinary bladder catheterization (CPT codes 51701, 51702, and 51703) is not separately reportable with a surgical procedure when performed at the time of or just prior to the procedure. Additionally, many procedures involving the urinary tract include the placement of a urethral/bladder catheter for postoperative drainage. Because this is integral to the procedure, placement of a urinary catheter is not separately reportable.