Urology Coding Alert

Question: Our clinic bills the following procedure codes for cystometrograms (CMGs): 51726, 51795 and 51797 with no modifiers. Code 51797 is being denied as inclusive with major procedure 51726. Can these three procedures be billed together? Should we use a modifier?

Anonymous Virginia Subscriber

Answer: These three procedures can be billed at the same time and should be paid without a modifier. The CMG51726 (complex cystometrogram [e.g., calibrated electronic equipment])is done to measure pressure and flow into the bladder. The complex CMG includes a transducer which is connected to electronic equipment. For 51795 (voiding pressure studies [VP]; bladder voiding pressure, any technique), the urologist measures the urine flow rate and pressure during bladder emptying by a transducer in the bladder. For 51797 (voiding pressure studies [VP]; intra-abdominal voiding pressure [AP] [rectal, gastric, intraperitonea]), the urologist places the transducer in the abdomen. There is no reason why a payer would consider 51726 as inclusive of 51797 since in 51726 the transducer is placed in the bladder and in 51797 the transducer is placed in the abdomen.