AUA-Recommendations-on-Coding-for-Xiaflex

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Feb 20, 2024

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3/15/2017 AUA HP Brief http://www.auanet.org/advnews/hpbrief/view.cfm?i=2857&a=5640 1/2 ShareThis Print Article January 7, 2014 The essential resource for your practice Volume XXI, Number 1 Table of Contents Summary of the 2014 Medicare Physician Fee Schedule Final Rule Practices Prepare for Open Payments Implementation Senate Makes Last Minute Votes Before Session Adjourns For the Record: GAO Report: HHS Should Do More To Improve Qualified Clinical Data Registry Use Registration Closing Soon: Sign up for the QI Summit Now Coding for New Medical Treatment of Peyronie’s Disease AUA Recommendations on Coding for Xiaflex Coding Corner: New Codes for Prostate Pathology Services Contractors and Trading Partners to Test ICD‐10 Starting March 3 Register for the CMS Webinar on Quality Resource Use Reports (QRURs) Implementation of Ordering and Referring Denial Edits AUA Recommendations on Coding for Xiaflex Procedure Code Descriptor CPT Code(s) RVUs Visit 1 Induce erection Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine) 54235 2.67 This procedure is performed to determine where the injection of Xiaflex should be administered on the penis. Detumese Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular 96372 0.71 If the tumesence does not detumese on its own, then an injection of a medication to pharmacologically detumese the penis is necessary. This code covers the injection of the medication. Anesthetic Not billable An injection of a numbing agent is included in all procedures. This code does not represent an injection of numbing agent but a nerve block into the nerve bundles outside of the prostate. Most urologists will not perform this procedure. Xiaflex Medication code J0775 Injection for Peyronie disease Injection procedure for Peyronie disease; 54200 3.21 The injection procedure has a 10‐day global period. In order to receive reimbursement for the second 54200 injection, the initial operative report must include documentation that an additional injection procedure will be required in the next 24‐ 72 hours. The modifier 58 staged procedure must be appended to the second 54200 procedure. Visit 2 Xiaflex Medication code J0775 Injection for Peyronie disease Injection procedure for Peyronie disease; 54200 ‐ 58 3.21 **Modifier to be used for injection visit 2 ‐ Since injection for peyronie disease has a 10 day global period, the 58 staged procedure modifier should be used. Visit 3
3/15/2017 AUA HP Brief http://www.auanet.org/advnews/hpbrief/view.cfm?i=2857&a=5640 2/2 Modeling Procedure There is one Evaluation and Management (E&M) Service CPT code 99212 included in the 10‐day global period of 52400. A separate E&M visit cannot be billed during the global period. Return Home Disclaimer | Archives | AUAnet.org
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