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Urology Coding Alert

You Be the Coder:

Fall Back on Documentation Details

Published on Mon Mar 13, 2023

Question: How would I code this encounter? The test was conducted in our clinic and the urologist noted N40.1 (Benign prostatic hyperplasia with lower urinary tract symptoms) and R35.0 (Frequency of micturition) as the diagnoses. The documentation for the uroflowmetry is: “Today’s uroflow was reviewed with the patient. Patient was able to void 250 cc with a peak of 9.7 cc/s [...]
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