Find out about reimbursement

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
N13.721: Unilateral
N13.722: Bilateral
N13.729: Unspecified
N13.73: VUR with reflux nephropathy with hydroureter
N13.731: Unilateral
N13.732: Bilateral
N13.739: Unspecified

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

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.