Can we report code A4353 (intermittent urinary catheter, with insertion supplies) with code 51703 (insertion of temporary indwelling bladder catheter; complicated)? When we perform a urinary catheterization, should we report modifier 25 with the evaluation and management (E/M) service?

Code 51703 is used to report the insertion of a temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon). If a simple urinary catheterization was performed (eg, temporary indwelling catheter), code 51702 should be reported. If a non-indwelling or straight catheter was inserted, code 51701 is appropriate. The medical record documentation and diagnosis should support the performance and medical necessity of the procedure. Most payers will require modifier 25 to be appended to the E/M service to indicate that it was significant and separately identifiable from the procedure. The Medicare Resource-Based Relative Value Scale values for codes 51701–51703 include the catheter supplies. Therefore, code A4353 should not be reported separately...

You do not currently have access to this content.