CPT® Code 53865

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

The procedure described by CPT® Code 53865 involves cystourethroscopy with the insertion of a temporary device aimed at ischemic remodeling of the bladder neck and prostate. This procedure is typically indicated for patients suffering from an enlarged prostate, which can lead to lower urinary tract symptoms. The temporary device serves as an alternative treatment option to more invasive procedures such as transurethral resection or other methods that involve the destruction of prostate tissue. The device itself is constructed from a biocompatible super-elastic shape memory alloy known as nitinol, which allows it to adapt to the anatomy of the patient while minimizing tissue damage. The device is designed to be left in place for a duration of five to seven days, during which it applies gentle pressure to reshape the prostatic urethra at the bladder neck level. This reshaping process aims to widen the urethra, facilitating improved urine outflow without the need for thermal destruction or removal of any tissue. The procedure is performed using a rigid cystourethroscope, which is inserted through the urethra and advanced into the bladder for inspection. Following the initial inspection, the cystoscope is removed, and the endoscopic sheath remains in place to facilitate the deployment of the temporary remodeling device. The precise positioning of the device is critical to ensure optimal outcomes while avoiding damage to the sphincter and preventing device migration. After the designated period, the device is removed in a separate procedure under local anesthesia, ensuring that the patient experiences minimal discomfort and a streamlined recovery process.