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Urology Coding Alert

Reader Question:

Say Goodbye to Inappropriate Payments for Urodynamic Studies

Published on Sun Jan 16, 2011

Question: I am with the billing office for a urologist and am having an issue with reimbursement for urodynamics. Our office is billing for 51798, 51741, 51726 based on the doctor's instructions. The payer isn't reimbursing correctly on the cystometrogram with voiding pressure. They are paying less than cystometrogram alone. Am I coding incorrectly? Florida Subscriber Answer: In 2010 and 2011 the relative value units (RVUs) were erroneously higher for code 51726 (Complex cystometrogram [ie calibrated electronic equipment]), than they were for the more complicated 51728 (Complex cystometrogram with voiding pressure studies [bladder voiding pressure] ...). This resulted in inappropriately higher payments for 51726 than for 51728. This was a mistake on the part of CPT® and will be corrected on Jan. 1, 2012. In 2012, RVUs have been corrected and 51728 will have RVUs of 9.24 while 51726 will have RVUs of 8.61 effective Jan. 1, 2012.
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