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Submitting Clean Claims in 2003
The lesson that I've learned from the the revised 2003 CPT codes? If you expect to be paid, your codes must be very specific about what was done, where it was done and how it was done. It doesn't hurt to learn why it was done, either. I've selected a few new CPT codes to illustrate my point.
Catheter insertion
The new CPT code for insertion of an intraperitoneal cannula or catheter is 49419. It supplements existing codes 49420, 49421, 49422, 49423 and 49424. When preparing/dictating the operative note, physicians should include:
- Type of cannula/catheter. Different codes pertain to different types of devices, so make sure to indicate whether the device is temporary, permanent, or a totally implantable permanent catheter with a subcutaneous reservoir.
- Type of cannula/ catheter procedure. Indicate whether the surgeon inserted, removed or exchanged the device. Another possibility is that the procedure involved a contrast injection for diagnostic assessment of the patient.
 Three codes have been added (51701, 51702 and 51703) and two deleted (53670 and 53675) for bladder catheterizations. Document whether the surgeon inserted a non-indwelling (51701) or temporary (51702 for simple and 51703 for complicated) indwelling catheter. Secondly, indicate the level of complexity of the procedure. Inserting a Foley catheter would be considered a simple procedure (51702). A patient with altered anatomy or the replacement of a fractured catheter or balloon would present sufficient surgical difficulty to use code 51703.
Contact Lolita M. Jones at 'lolitamj@aol.com').
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