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Last Modified: 8/1/2022 Location: FL, PR, USVI Business: Part A, Part B

Billing for temporary implantable female urological prosthesis, CPT codes 0596T and 0597T

Important reminders effective for claims with date of service on and after January 1, 2022

First Coast would like to remind providers of important billing tips for CPT codes 0596T and 0597T to void claim processing delays.
When billing for the initial visit (billed once), procedure code 0596T (temporary female intraurethral value-pump (i.e., voiding prosthesis); initial insertion, including urethral measurement):
Report the device using procedure code L8699 (prosthetic implant, not otherwise specified), and
Include a comment "inFlow intraurethral valve-pump" in item 19 or the electronic equivalent of the claim form
When billing procedure code 0597T (temporary female intraurethral value-pump (i.e., voiding prosthesis); replacement):
Report the device to the DME MAC per instructions outlined in the DME article A52521-Urological Supplies – Policy Article
It is not appropriate to bill device codes L8699 or A4335 with code 0597T
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