CPT® Code 0548T

Code deleted, see 53451, 53452, 53453, 53454

Official Description

Transperineal periurethral balloon continence device; bilateral placement, including cystoscopy and fluoroscopy

Common Language Description

The CPT® Code 0548T refers to the procedure involving the transperineal placement of a periurethral balloon continence device, specifically designed for bilateral placement. This procedure is primarily indicated for men experiencing urinary incontinence, particularly following prostate surgery or radiation therapy. The device aims to restore normal pelvic pressure and improve urinary continence by utilizing a balloon mechanism that can be adjusted post-operatively. The procedure involves several technical steps, including the use of a cystoscope, which is a specialized instrument that allows visualization of the bladder through the urethra. The placement of the device is guided by fluoroscopy, ensuring accurate positioning within the pelvic region. The process includes making a small incision in the perineum, inserting a trocar and sheath, and advancing the balloon device to the appropriate location. The balloon is then inflated to secure it in place, and the procedure is repeated on the opposite side for bilateral placement. This comprehensive approach allows for effective management of urinary incontinence, providing patients with a potential solution to improve their quality of life.

1. Indications

The transperineal periurethral balloon continence device placement is indicated for the following conditions:

Urinary Incontinence This procedure is performed on men who experience urinary incontinence, particularly as a result of prostate surgery or radiation therapy.

2. Procedure

The procedure for the transperineal placement of a periurethral balloon continence device involves several detailed steps to ensure proper placement and functionality of the device.

Step 1: Cystoscopy A cystoscope is introduced through the urethra into the bladder to allow visualization of the internal structures and to guide the subsequent steps of the procedure.
Step 2: Incision and Trocar Insertion A sharp-tipped trocar and sheath are assembled, and a small incision is made in the perineum. Under fluoroscopic guidance, the trocar and sheath are inserted through this incision and advanced through the pelvic floor.
Step 3: Advancement to the Bladder The sharp-tipped trocar is replaced with a blunt-tipped trocar to facilitate safer advancement. The trocar is then advanced to the level of the bladder, ensuring that it is positioned correctly.
Step 4: Balloon Device Placement Once the trocar is removed, the deflated balloon device is advanced through the sheath to the desired location within the periurethral area. The sheath is then partially retracted, and the balloon is inflated with a small amount of fluid to anchor it securely in place.
Step 5: Closure After the balloon is inflated, the sheath is removed, and the incision in the perineum is closed to complete the procedure. For bilateral placement, the entire procedure is repeated on the opposite side.

3. Post-Procedure

Following the procedure, patients typically undergo a recovery period of a few weeks. During this time, the device may be accessed using a needle inserted through the perineum to adjust the balloon volume for adequate pressure. This adjustment can be performed multiple times until the optimal balloon inflation volume is achieved. If removal of the device is necessary, a small incision is made in the perineum, the balloon is deflated, and the device is carefully dissected free from surrounding tissue before being removed.

Short Descr	TPRNL BALO CNTNC DEV BI
Medium Descr	TPRNL BALO CNTNC DEV BI PLMT W/CSTSC & FLUOR
Long Descr	Transperineal periurethral balloon continence device; bilateral placement, including cystoscopy and fluoroscopy
Status Code	Carriers Price the Code
Global Days	YYY - Carrier Determines Whether Global Concept Applies
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	Hospital Part B services paid through a comprehensive APC
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.