How To Use CPT Code 52287

CPT 52287 refers to a cystourethroscopy procedure with injections for chemodenervation of the bladder. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 52287.

1. What is CPT 52287?

CPT 52287 is a medical procedure code used to describe a cystourethroscopy with injections for chemodenervation of the bladder. This procedure is performed to treat an overactive bladder by injecting a neurolytic drug into the affected bladder muscle, which weakens the muscle and reduces its overactivity.

2. 52287 CPT code description

The official description of CPT code 52287 is: “Cystourethroscopy, with injection(s) for chemodenervation of the bladder.”

3. Procedure

The 52287 procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider inserts a cystoscope (a lighted tubular instrument) through the urethra into the bladder.
3. The provider examines the interior of the bladder, the urethra, and the ureteric openings for any abnormalities.
4. The provider locates the overactive bladder muscles.
5. A neurolytic drug is injected through the cystoscope into the affected muscle.
6. The drug destroys nerve tissue in the muscle, weakening it and reducing its overactivity.
7. The provider removes the cystoscope once the procedure is complete.

4. Qualifying circumstances

Patients eligible to receive CPT code 52287 services are those diagnosed with an overactive bladder that has not responded to conservative treatments such as medication, pelvic floor exercises, or bladder training. The procedure is typically recommended for patients who experience symptoms such as urinary urgency, frequency, and incontinence that significantly impact their quality of life.

5. When to use CPT code 52287

It is appropriate to bill the 52287 CPT code when a provider performs a cystourethroscopy with injections for chemodenervation of the bladder to treat an overactive bladder that has not responded to conservative treatments. The procedure should be considered as a treatment option when the patient’s symptoms significantly impact their daily activities and quality of life.

6. Documentation requirements

To support a claim for CPT 52287, the following information needs to be documented:

• Patient’s medical history and diagnosis of overactive bladder.
• Conservative treatments attempted and their outcomes.
• Indication that the patient’s symptoms significantly impact their quality of life.
• Details of the cystourethroscopy procedure, including the type and dosage of the neurolytic drug used.
• Post-procedure assessment and follow-up plan.

7. Billing guidelines

When billing for CPT code 52287, it is essential to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT 52287 include:

• Ensure that the patient’s medical record supports the medical necessity of the procedure.
• Document all conservative treatments attempted and their outcomes.
• Use the appropriate ICD-10 diagnosis code to support the claim.
• Remember that the supply of the chemodenervation agent is reported separately.

8. Historical information

CPT 52287 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Similar codes to CPT 52287

Five similar codes to CPT 52287 and how they differentiate from CPT 52287 are:

1. CPT 52204: This code involves a cystourethroscopy with biopsy(s) of the bladder and/or urethra.
2. CPT 52214: This code describes a cystourethroscopy with fulguration or treatment of a minor lesion.
3. CPT 52224: This code refers to a cystourethroscopy with fulguration or treatment of a medium-sized lesion.
4. CPT 52234: This code involves a cystourethroscopy with fulguration or treatment of a large lesion.
5. CPT 52260: This code describes a cystourethroscopy with treatment of a urethral stricture or diverticulum.

10. Examples

Here are 10 detailed examples of CPT code 52287 procedures:

1. A 55-year-old female with a history of urinary urgency and frequency undergoes CPT 52287 after failing conservative treatments.
2. A 65-year-old male with urinary incontinence and a history of overactive bladder undergoes CPT 52287 to reduce symptoms.
3. A 45-year-old female with a history of recurrent urinary tract infections and overactive bladder undergoes CPT 52287 after conservative treatments fail to improve her symptoms.
4. A 60-year-old male with a history of prostate enlargement and overactive bladder undergoes CPT 52287 to alleviate urinary urgency and frequency.
5. A 50-year-old female with a history of pelvic organ prolapse and overactive bladder undergoes CPT 52287 to improve her quality of life.
6. A 70-year-old male with a history of neurogenic bladder and overactive bladder undergoes CPT 52287 to reduce urinary incontinence.
7. A 40-year-old female with a history of interstitial cystitis and overactive bladder undergoes CPT 52287 to alleviate symptoms.
8. A 75-year-old male with a history of bladder cancer and overactive bladder undergoes CPT 52287 to improve urinary control.
9. A 55-year-old female with a history of multiple sclerosis and overactive bladder undergoes CPT 52287 to reduce urinary urgency and frequency.
10. A 65-year-old male with a history of spinal cord injury and overactive bladder undergoes CPT 52287 to improve bladder function.