Urology Coding Alert

• In a simple CMG (CPT 51725 , Simple cystometrogram [e.g., spinal manometer]), the urologist places a small catheter in the bladder, filling the bladder by gravity and measuring capacity and storage pressures using a spinal manometer.

• A complex CMG (CPT 51726 , Complex cystometrogram [e.g., calibrated electronic equipment]) involves filling the bladder through a catheter and measuring the pressure with calibrated electronic equipment.

• During a simple UFR (51736, Simple uroflowmetry [e.g., stopwatch flow rate, mechanical uroflowmeter]), the urologist visually observes the urine flow, sometimes using a stopwatch to gauge the flow.

• A complex UFR (51741, Complex uroflowmetry [e.g., calibrated electronic equipment]) makes use of special electronic equipment to measure the urine flow.

• EMG studies (51784, Electromyography studies of anal or urethral sphincter, other than needle, any technique), in which the urologist places patch electrodes around the urethral sphincter to measure electrical and muscular activity of the perineal muscles and urinary sphincter, are usually performed with a complex CMG (51726) or a VP study.

• A needle EMG (51785, Needle electromyography studies of anal or urethral sphincter, any technique) involves placing needles into the pelvic floor to measure muscle activity during bladder filling and at rest. Your urologist may perform a needle EMG with other urodynamic studies. Now, few urologists use needle electromyography.

• Stimulus evoked response (51792, Stimulus evoked response [e.g., measurement of bulbocavernosus reflex latency time]) involves stimulating the sacral arch via the glans or clitoris and measuring motor activity in the pelvic floor or urethral sphincter. Urologists rarely perform this test.

• VP studies (51795, Voiding pressure studies; bladder voiding pressure, any technique; and +51797, ... intra-abdominal voiding pressure [AP] [rectal, gastric, intraperitoneal]) measure specific pressures during voiding. For 2008, 51797 became an add-on code, which you can exclusively report with 51795 as the primary code. Remember, for add-on codes, do not append modifier 51 (Multiple procedures) or reduce their charges.