Deflux reimbursement information
While all coding decisions should be made by the physician based on independent review of the patient’s condition, below is a list of codes you may find helpful.
HCPCS medication information
L8604: Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies
Note: Uniform coding standards require the use of L8604 on all claims related to its use regardless of payer type
ICD-10-CM diagnosis codes
Providers should report the code that best reflects the reason why each individual patient received the Deflux implant. The following codes reflect common reasons for the use of Deflux but do not necessarily imply coverage for these diagnoses.
N13.7: Vesicoureteral reflux (VUR)
N13.70: VUR, unspecified
N13.71: VUR without reflux nephropathy
N13.72: VUR with reflux nephropathy without hydroureter
N13.73: VUR with reflux nephropathy with hydroureter
CPT administration code
52327: Cystourethroscopy with subureteric injection of implant material
Note: Surgical cystoscopy always includes diagnostic cystoscopy and should not be reported separately.
Revenue codes are used to assign costs to hospital-specific accounting centers and are reported on facility claim forms (UB04). The following revenue codes may be appropriate; however, facilities should report the code that is consistent with their own accounting procedures.
278: Other implants (Deflux syringe and needle)
36X or 49X: General surgery or ambulatory surgery (Implant procedure)
Deflux reimbursement hotline: 1-844-350-9656
For full information on Deflux reimbursement, please download the Deflux Reimbursement Guide here.
The information provided represents no statement, promise or guarantee of Palette Life Sciences, Inc. concerning levels of reimbursement, payment or charge. Please consult your payer organization with regard to local or actual coverage, reimbursement policies and determination processes.