CPT® Code 53866

Official Description

Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate

Common Language Description

The procedure described by CPT® Code 53866 involves the removal of a temporary ischemic remodeling device that has been used to treat conditions related to the bladder neck and prostate, specifically for cases of pressure necrosis. This device is designed to apply pressure to the prostatic urethra, effectively reshaping and widening it to facilitate improved urine outflow. This is particularly beneficial for patients experiencing symptoms associated with benign prostatic hyperplasia (BPH), a condition characterized by an enlarged prostate that can obstruct urinary flow. The device is typically implanted for a duration of five to seven days, during which it exerts pressure to remodel the affected area. Prior to the removal of the device, topical intraurethral lidocaine jelly is applied to minimize discomfort during the procedure. The removal process involves the use of a retrieval grasper and a retrieval suture, ensuring that the device is extracted safely and effectively through the urethra. This procedure is crucial for alleviating urinary symptoms and restoring normal urinary function in patients suffering from BPH-related complications.

1. Indications

The procedure associated with CPT® Code 53866 is indicated for patients experiencing symptoms related to benign prostatic hyperplasia (BPH) that may include:

Urinary Obstruction Difficulty in urination due to an enlarged prostate that compresses the urethra.
Pressure Necrosis Tissue damage at the bladder neck and prostate due to prolonged pressure, necessitating intervention.
Urinary Retention Inability to completely empty the bladder, leading to discomfort and potential complications.

2. Procedure

The procedure for the removal of the temporary ischemic remodeling device involves several key steps:

Step 1: Preparation Prior to the removal, topical intraurethral lidocaine jelly is applied to the urethra to provide local anesthesia and minimize discomfort during the procedure.
Step 2: Insertion of Retrieval Grasper A retrieval grasper is introduced through the catheter, which is used to grasp the retrieval suture attached to the temporary remodeling device.
Step 3: Advancement of Catheter The retrieval suture is passed through the catheter, and the catheter is advanced through the urethra over the suture string until it reaches the location of the temporary device.
Step 4: Application of Pressure Once the catheter is in position, firm and steady pressure is applied to the retrieval suture string, which facilitates the safe pulling of the temporary remodeling device into the catheter.
Step 5: Removal The device is then carefully removed from the urethra through the catheter, completing the procedure.

3. Post-Procedure

After the removal of the temporary ischemic remodeling device, patients may be monitored for any immediate complications or discomfort. It is important to assess urinary function and ensure that the patient can urinate without obstruction. Follow-up care may include instructions on managing any residual symptoms and monitoring for signs of infection or other complications. Patients are typically advised to report any unusual symptoms, such as increased pain or difficulty urinating, to their healthcare provider promptly.

Short Descr	CATHJ RMVL DEV ISCHMC RMDLG
Medium Descr	CATHJ RMVL TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8
Long Descr	Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate
Status Code	Active Code
Global Days	000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	2 - Standard 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)	1 - Statutory 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	Procedure or Service, Multiple Reduction Applies
ASC Payment Indicator	Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs.
Type of Service (TOS)	2 - Surgery
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.