Urology Coding Alert

Question: We have a new doctor and new nurses who are performing pelvic floor therapy and are not sure how to code. I don't know if I need modifiers or whether unbundling is allowed for all of these codes: 99211, 97750, 91122, 51784, 97032. Can you please tell me how to report these services?

Michigan Subscriber

Answer: You have chosen the proper codes. You should report pelvic floor therapy services as follows:

• 99211 (Office or other outpatient visit for the evaluation and management of an established patient ...). Append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to show your payer that the E/M service is separate from the surgical procedure you'll also bill.

• 51784 (Electromyography studies [EMG] of anal or urethral sphincter, other than needle, any technique)

• 91122 (Anorectal manometry)

• 97750-GP (Physical performance test or measurement [e.g., musculoskeletal, functional capacity], with written report, each 15 minutes). Append modifier GP (Services delivered under an outpatient physical therapy plan of care) to indicate this is a planned physiotherapy service

• 97032-GP (Application of a modality to one or more areas; electrical stimulation [manual], each 15 minutes).

Good news: There are no bundling edits with these codes, so you can report them together.

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.