Urology Coding Alert

Question: What is the difference between CPT 76775 and CPT 51798? I know it has to do with the imaging, but what differences in imaging should we look for? And should we use one of the codes for private carriers and the other for Medicare, or can both codes be submitted to both carriers?

UCA Subscriber

Answer: Choosing between the requirements for 76775 and 51798 has been a hot topic since CPT 2003 instructed coders to replace the former G code G0050 with 51798 (Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging).

The first thing you should understand before using these codes is that both codes can and probably will need to be submitted both to private and Medicare carriers.

The second thing you should know is that 51798 should only be used when using simple hand-operated, sonographic equipment that gives the volume of residual urine but does not provide an image. When you report 51798, you can expect to be paid an average of $19.02. This code should also be used for portable, handheld devices that are used to calculate residual urine.

CPT code 76775 (Ultrasound, retroperitoneal [e.g., renal, aorta, nodes], B-scan and/or real time with image documentation; limited), on the other hand, should be used when a standard ultrasonic machine is used to calculate the volume of residual urine from imaging, and this code pays an average of $80.21 when both the professional and technical components are billed combined. These images are typically ultrasound images of the bladder and its contents, and if these images are used to calculate the residual urine, you should report 76775 both to private and Medicare carriers.