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UCR 136: Prehab clinic coding (PT/Dietician before surgery), straight catheter billing - 51701 v P9612?

March 10, 2023

Mark, Ray, and Scott discuss questions that came into the PRS Community.  

  1.  We want to do a prehab clinic for patients to improve conditions before surgery. They would be using a PT/Dietician to help improve post op complications. The reason we are contacting you is we are trying to find out the best coding scenario for this. What would you suggest regarding CPT/DX? Would we be able to do an E/M with coding such as muscle weakness etc.?
  2. We are having an issue with BCBS Medicare advantage claiming we are using 51701 inappropriately.  I was not aware there were other codes for passing a straight catheter, but it was brought to our attention that we should be using P9612.  Have you guys run into this before? any guidance you can offer in clarification of the use of 51701.  When i was looking into this P9612 is also implying taking the urine sample from an indwelling SPT or foley, not necessarily the act of placing the disposable straight catheter in the patient to collect the sample.  
    Have you guys seen this?  what are your thoughts on 51701 vs P9612.  This is my first time seeing this.

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