Optilume CPT Coding Guidance for Urethral Stricture and Stenosis

What Is Optilume?

Optilume is an FDA approved drug-coated balloon, developed by Urotronic, that is inserted via cystoscopy to dilate and treat urethral strictures or stenosis caused by benign prostatic hyperplasia (BPH). It is a minimally invasive procedure that provides immediate relief from the urinary symptoms men can experience with BPH. 

A CPT code, 52284, was introduced in 2024 which can be used when a cystoscopy with Optilume is performed. 

The drug on the outer surface of this balloon (paclitaxel), once absorbed, may help maintain the stricture expansion and help improve urinary flow. The balloon is not left inside the patient, but rather taken out after 5 minutes of inflation, leaving the drug to do its job with the rest. 

Key Coding Considerations for Coders

• Use CPT 52284 only when a drug-coated balloon (like Optilume) is used during cystoscopy to treat urethral stricture/stenosis.
• Documentation must clearly state:
• Use of Optilume
• Paclitaxel drug delivery
• Balloon inflation and removal
• Do not code separately for the drug 
• Use C1889 for the device code
• Ensure the diagnosis supports stricture/stenosis, not just BPH.
• This code is new in 2024—don’t use it for earlier dates.
• Watch for bundling and use modifiers only if appropriate.
• Check payer policies for coverage and authorization requirements