Urology Coding Alert

Question: I am trying to optimize coding and reimbursement for urodynamic studies. Currently, we use 51726 (complex cystometrogram [eg, calibrated electronic equipment]), 51741 (complex uroflowmetry [eg, calibrated electronic equipment]), 51785 (needle electromyography studies [EMG] of anal or urethral sphincter, any technique), 51795 (voiding pressure studies [VP]; bladder voiding pressure, any technique) and 51797 (intra-abdominal voiding pressure [AP] [rectal, gastric, intraperitoneal]) for our urodynamic codes. Would you suggest any other codes? Another source had recommended using 51600 and 74455. What is your experience with these?

Connecticut Subscriber

Answer: You should bill for all services performed and provided to the patient by the physician. You can bill for 51600 (injection procedure for cystography or voiding urethrocystography) and 74455 (urethrocystography, voiding, radiological supervision and interpretation) in conjunction with any of the other codes listed if the physician is performing these services. As for bundling, the codes that are considered a component of 51600 are 51610 (injection procedure for retrograde urethrocystography), 52005 (cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service), 52281 (cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female), and 74450 (urethrocystography, retrograde, radiological supervision and interpretation).

These procedures if performed in conjunction with 51600 should not be reported separately per Medicares national Correct Coding Initiative (CCI) policy edits.