Ob-Gyn Coding Alert

With so many urodynamic study codes, linking them to the appropriate procedure is essential. Use this list to link the procedure with the proper code: Voiding pressure studies (51795, Voiding pressure studies [VP]; bladder voiding pressure, any technique; and 51797, ... intra-abdominal voiding pressure [AP] [rectal, gastric, intraperitoneal]) evaluate different functions. Code 51795 refers to measuring the detrusor muscle's ability to contract. Code 51797 refers to a procedure to compare intra-abdominal pressure to detrusor muscle function. Ob-gyns often use 51795 and 51726 to diagnose obstruction. The cystometrogram (51725, Simple cystometrogram [CMG] [e.g., spinal manometer]) indicates if the detrusor muscle is functioning properly. The test detects the bladder's capacity and abnormal detrusor sphincter contractions.

If the patient's incontinence is stress-induced, the CMG results are within the normal range. You would use 51726 (Complex cystometrogram [e.g., calibrated electronic equipment]) when you have calibrated electronic equipment that performs simultaneous measurements of intra-abdominal, total bladder and true detrusor pressures. Ob-gyns use uroflowmetry procedures (51736, Simple uroflowmetry [UFR] [e.g., stop-watch flow rate, mechanical uroflowmeter]; and 51741, Complex uroflowmetry [e.g. calibrated electronic equipment]) to measure decreased flow. Decreased flow indicates a malfunctioning detrusor due to a cystocele (618.x), neurologic lesions, or other reasons. Increased flow shows a malfunctioning urethra, which can lead to stress incontinence or intrinsic sphincter dysfunction. Report urethral pressure studies (51772, Urethral pressure profile studies [UPP] [urethral closure pressure profile], any technique) only if the patient has an artificial urinary sphincter. Generally, payers do not reimburse for this test unless other urodynamic tests are inconclusive. A final diagnostic tool is stimulus-evoked response (51792, Stimulus-evoked response [e.g., measurement of bulbocavernosus reflex latency time]). During this procedure, the physician applies electric stimulation to the clitoris. A delayed or lack of response to the stimulation may indicate a neurologic lesion.