Procedure #1: What CPT and HCPCS am I going to bill?
PST: Informed consent given. Pt. placed in dorsolithotomy position. After cleansing patient with iodine swabs, bladder was cathed using a straight cath. 40 cc of Solution A was instilled in the bladder. After two minutes, patient is asked to rate the discomfort and urgency on a scale of 0-4 with 4 being the worst they could imagine. Water is drawn off and 40 cc of Solution B was instilled into the bladder. After two minutes, patient is again asked to rate the discomfort and urgency on a scale of 0-4, considering their baseline.
Solution A: Normal Saline Solution
Ratings: Discomfort2 Urgency 0
B: Potassium solution: 20 cc KCL, 80 cc normal saline
Ratings: Discomfort4 Urgency 4
Treatment Rescue Solution: 4 cc Heparin, 10,000 units/cc, 5 cc lidocaine 1%, 10 cc sodium bicarb, 5 cc Marcaine.
Rescue Solution was instilled in the bladder and pt. was instructed to retain fluid for at least 1/2 hour, but up to 2 hours before urinating.

Procedure #2: What CPT and/or HCPCS am I going to bill?
Pt placed in dorsolitotomy position. After cleansing with betadine swabs x 3, pt. was catherized with a straight cath. Treatment Rescue solution: 4 cc Heparin, 10,000 units/cc, 5 cc lidocaine 1%, 10 cc sodium bicarb, 5 cc Marcaine was instilled into the bladder. Pt. instructed to leave solution in bladder for 1/2 hour to 2 hours before urinating. Pt. tolerated procedure well.