2025 CPT code 51720
(Active) Effective Date: N/A Revision Date: N/A Surgery - Introduction Procedures on the Bladder Surgery Feed
Bladder instillation of an anticarcinogenic agent, including the retention time.
Modifiers may be applicable, such as modifier 59 for a distinct procedural service if performed separately from other procedures, or other modifiers based on individual circumstances and payer requirements.
Medical necessity for CPT 51720 is established by the presence of a diagnosed bladder cancer requiring intravesical chemotherapy or immunotherapy. The choice of agent and frequency of instillation should be supported by clinical guidelines.
The physician or qualified healthcare professional is responsible for performing the pre-procedure evaluation, obtaining informed consent, positioning the patient, inserting the catheter, administering the anticancer agent, monitoring the patient during the retention time, draining the bladder, providing post-procedure care and instructions, and documenting the procedure.
In simple words: This is a treatment for bladder cancer where medicine is put directly into the bladder through a thin tube. The medicine stays in the bladder for a while before being drained. This helps to kill cancer cells.
CPT code 51720 represents the procedure of bladder instillation of an anticarcinogenic agent.This involves the introduction of a chemotherapy drug directly into the bladder via a catheter. The agent is retained in the bladder for a specified duration before being drained.This technique is commonly used in the treatment of bladder cancer.The procedure includes pre-procedure evaluation, consent, positioning, instillation, and post-procedural care.It is considered a 0-day global procedure.
Example 1: A patient with superficial bladder cancer undergoes transurethral resection of bladder tumor(s).Following the resection, an intravesical instillation of gemcitabine is performed. CPT 51720 is reported for the instillation, potentially with modifier 59 if performed later the same day as a distinct service., A patient diagnosed with high-risk non-muscle-invasive bladder cancer receives a scheduled intravesical instillation of Bacillus Calmette-Guérin (BCG) as part of their adjuvant therapy. CPT 51720 is reported for each instillation, along with appropriate documentation of the substance administered and the retention time., A patient presents with recurrent bladder cancer. Following cystoscopy and biopsy, the physician decides to perform an intravesical chemotherapy instillation. CPT 51720 is reported, along with the specific chemotherapy code administered.
* Detailed history and physical examination, noting the diagnosis and indication for intravesical instillation.* Documentation of the type and amount of anticarcinogenic agent administered.* Precise documentation of the instillation procedure, including catheterization technique and retention time.* Documentation of patient tolerance and any adverse events.* Post-procedure instructions provided to the patient.* Physician's assessment of the clinical response and plan for further treatment.
** Always refer to the most current CPT codebook and payer guidelines for the most up-to-date information on coding, billing, and reimbursement for CPT code 51720.The use of modifier 59 should be carefully considered and justified in the documentation.
- Revenue Code: P7B (ONCOLOGY - OTHER)
- RVU: Information on RVUs requires reference to current fee schedules and may vary by payer and location.
- Global Days : 0-day global procedure.All services including pre-procedure evaluation, consent, positioning, instillation, and post-procedural care are included in the code.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule : Historical fee schedule data requires consulting relevant payer fee schedules.
- Specialties:Urology, Oncology
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)