CPT® Code 0193T | Case2Code

Code deleted, see 53860.

Official Description

Transurethral, radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence

Common Language Description

The procedure described by CPT® Code 0193T involves a specialized technique known as transurethral radiofrequency micro-remodeling, specifically targeting the female bladder neck and proximal urethra. This intervention is primarily indicated for the treatment of stress urinary incontinence, a condition often resulting from hypermobility of the bladder neck. During the procedure, a physician utilizes low-temperature radiofrequency energy to effectively remodel the submucosal tissue within the bladder neck and urethra. This remodeling process is designed to enhance the function of the urinary tract without leading to any narrowing or thickening of the lumen, which is crucial for maintaining normal urinary flow. To initiate the procedure, a local anesthetic is administered to ensure patient comfort. Following this, a transurethral probe is carefully inserted into the urethra. The physician then applies controlled radiofrequency energy to specific target sites within the lower urinary tract. This application of energy results in collagen denaturation at multiple small treatment sites, which is a key aspect of the procedure. As the tissue undergoes healing, the treated areas develop increased resistance to intra-abdominal pressure. This physiological change is significant as it contributes to the reduction or complete elimination of involuntary urine leakage, thereby addressing the symptoms associated with stress urinary incontinence effectively.

1. Indications

The transurethral radiofrequency micro-remodeling procedure is indicated for the treatment of stress urinary incontinence, particularly in cases where the condition is attributed to hypermobility of the bladder neck. This condition is characterized by involuntary leakage of urine during activities that increase abdominal pressure, such as coughing, sneezing, or physical exertion.

Stress Urinary Incontinence This condition occurs when there is a loss of bladder control, leading to involuntary leakage of urine during physical activities that increase abdominal pressure.
Hypermobility of the Bladder Neck This refers to the abnormal movement of the bladder neck during activities, which can contribute to the development of stress urinary incontinence.

2. Procedure

The procedure consists of several key steps that ensure effective treatment of stress urinary incontinence.

Step 1: Administration of Local Anesthetic Prior to the procedure, a local anesthetic is administered to the patient to minimize discomfort during the intervention. This step is crucial for ensuring patient comfort and cooperation throughout the procedure.
Step 2: Insertion of the Transurethral Probe Following the administration of anesthesia, the physician carefully inserts a transurethral probe into the urethra. This probe is specifically designed to deliver radiofrequency energy to targeted areas within the lower urinary tract.
Step 3: Application of Controlled Radiofrequency Energy Once the probe is in place, the physician applies controlled radiofrequency energy to the submucosal tissue at predetermined target sites. This energy application is performed with precision to ensure effective remodeling of the tissue without causing any adverse effects such as narrowing or thickening of the lumen.
Step 4: Collagen Denaturation The application of radiofrequency energy leads to collagen denaturation at multiple small treatment sites. This process is essential for initiating the remodeling of the tissue, which will contribute to improved function of the bladder neck and urethra.
Step 5: Healing Process After the procedure, the treated tissue undergoes a healing process. As the tissue heals, the treated sites develop increased resistance to intra-abdominal pressure, which is vital for reducing or eliminating involuntary leakage of urine.

3. Post-Procedure

Post-procedure care involves monitoring the patient for any immediate complications and providing instructions for recovery. Patients may experience some discomfort or mild urinary symptoms following the procedure, which typically resolve as healing progresses. It is important for patients to follow any specific post-operative instructions provided by their physician, including recommendations for activity levels and hydration. Follow-up appointments may be scheduled to assess the effectiveness of the procedure and to monitor for any potential complications.

Short Descr	RF BLADDER NECK MICROREMODEL
Medium Descr	TRANSURETHRAL RF BLADDER NECK MICROREMODEL
Long Descr	Transurethral, radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Significant Procedure, Multiple Reduction Applies
Type of Service (TOS)	2 - Surgery
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.
CCS Clinical Classification	109 - Procedures on the urethra