tci Outpatient Facility Coding Alert - 2014 Issue 7

Reader Question: Remember Many Payers Consider Renessa Experimental

Question: Mrs. Smith had Renessa as a treatment option for stress urinary incontinence. How should we report this service, and shall we be paid? Kentucky Subscriber Answer: The CPT® code for the Renessa procedure is 53860 (Transurethral, radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence). In 2011, CPT® deleted Category III code 0193T, replacing it with the new Category I code 53860 with the same descriptor. Red flag: Many payers, including some Medicare MACs, do not pay for this service as they still consider it experimental.  Best option: Check with the payer...

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