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How Codes Work Together

To report the patient's condition, the services rendered and supplies for claims processing, you must use codes from all three coding systems.

For example, here's how to code for a collagen skin test and implant for incontinence (CPT, HCPCS and ICD-9-CM) when performed in the physician's office. Note: For Medicare, it is required that a skin test for collagen sensitivity be administered and evaluated prior to consideration of the implant. The skin test should be billed:

Intracutaneous (intradermal) tests with allergenic extracts, delayed type reaction, including reading, specify number of tests

along with

HCPCS Q3031 Collagen Skin Test (Although this code receives no reimbursement, it should be reported as supportive documentation)

On the day of the procedure, the physician's service along with the cost of the implant would be billed:

Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck
HCPCS L8603 Collagen implant, urinary tract, per 2.5 cc syringe includes necessary supplies (specify number of injections in units on CMS 1500)

In addition, here are some ICD-9 diagnostic codes that the collagen skin test and the collagen implant might warrant to support medical necessity:

596.59 Other function disorder of bladder (detrusor instability)
596.8 Other specified disorders of the bladder
599.82 Intrinsic (urethral) sphincter deficiency [ISD]
625.6 Stress incontinence, female
753.9 Unspecified anomaly of urinary system
788.32 Stress incontinence, male
788.33 Mixed incontinence, (male or female) urge and stress
867.0 Injury to bladder and urethra, without mention of open wound into cavity
867.1 Injury to bladder and urethra, with open wound into cavity
V15.29 Other personal history presenting hazards to health, surgery to other organs
V15.3 Other personal history presenting hazards to health, irradiation


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