Urology Coding Alert

Question: We perform office urodynamic evaluations. We perform the Marshall-Marchetti-Krantz stress test and simplified cystometric evaluation to evaluate for urinary incontinence. Would you please give us some suggestions on how to code for these tests?

Ohio Subscriber

Answer: The Marshall-Marchetti-Krantz test is part of the evaluation and management (E/M) service, and you cant bill separately for it. (The test is done with the patient having a full bladder in the supine position; the patient strains down, and the physician determines whether there is any leakage of urine.) The simplified cystometric evaluation would be reported with 51725 (simple cystometrogram [CMG] [e.g., spinal manometer]).

In this procedure, the physician introduces a catheter into the bladder, which is connected to a manometer, which measures pressure in the lower urinary tract. If an electronic microtip pressure-transducer catheter is used, this would be reported using 51726 (complex cystometrogram [e.g., calibrated electronic equipment]). Note that urethral-pressure profile studies would not be done as a simple measurement of incontinence; rather, you would use these more complex CMGs if you were doing a whole battery of tests.

In a urethral-pressure profile study, the physician measures urethral pressure by pulling a transducer through the urethra to measure intra-urethral pressure. This would be reported with 51772 (urethral pressure profile studies [UPP] [urethral closure pressure profile], any technique). A urethral-pressure profile study produces a graphic representation of sphincter closure pressure, functional length, and continuous response to a specific provocative maneuver such as a cough.