Urology Coding Alert

Question: Which code should I use to report a Valsalva leak point test? We used to report 51795, but some fellow coders advised me to start using 51772. One doctor says this is not correct and wants more information.

South Carolina Subscriber

Answer: Report 51772 (Urethral pressure profile studies [UPP] [urethral closure pressure profile], any technique) for the Valsalva leak point pressure determination. In September 2003, the American Urological Association recommends using 51772 instead of 51795 (Voiding pressure studies [VP]; bladder voiding pressure, any technique), since 51772 more accurately describes the Valsalva procedure. The AMA concurred with a note in the Sep. 6, 2002, CPT Assistant.
 
Remember: According to CPT, "all supplies, equipment and technicians fees are provided by the physician" for urodynamics procedures 51725-51797. If you can prove that the supplies you used were over and above what 51772 usually includes, you may be able to bill for them with 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies or materials provided]). This certainly would be a very unusual event, however, and most carriers will not pay for these supplies.

 - Answers to Reader Questions and You Be the Coder contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook; and Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 31-urologist practice in Indianapolis.