Bring Your Urodynamic Medical Coding Under Control


And a lot of you who are doing urodynamics must be aware of the changes to the codes.  And this isn't the only changes in CPT with rebundling procedures that are done typically together at the same time.

This is no different than bundling into a panel of test. Instead of billing for the individual test, you bill for the panel because they're all done at the same time and there's no real increased work for each one being done separately which is what you have been paid for originally.

So what they've done is they've kept the code 51726. And they have been bundled the most typically inclusive procedures that are performed with that. So, as per the updated medical coding guidelines, we have a new code 51727 which is a urethral pressure profile study with the CMG.

51728 is avoiding pressure study done with the CMG. And 51729 is both the UPP and the VPS studies done with the CMG. Whereas you used to be able to code separately using codes 51772 and 51795. That's out of the ballpark now. You can't use those.

In addition, you will notice when we get to the RVU part that the allowables for these have also been decreased. So you're going to be paid less for doing these tests than you had been before. But again, the argument was that these are always done. And at the same time, there's not a lot of additional work involved in doing them and so that they should rightfully be bundled.

This is a CPT convention now, not something that CMS did. CPT is now going to begin looking for these kinds of services and using data just to back them up. And so you're going to see in the future a lot more bundles and medical coding updates like these.

They did retain code 51797. That's the abdominal pressure study. It is an add-on code. But the only two codes you can now report it with is 51728 and 51729, okay, because it's an add-on code for avoiding pressure study. It's an add-on to the old code 51795.

The other thing that you should know is that urethral pressure profile study includes the valsalva leak point pressure test. So this isn’t something that you can be billing for separately.

Coding and Compliance Update: We also have a new code for vaginal graft revision, 57426. This is a laparoscopic approach. So now, we have new code for – we have an old code for vaginal approach. We have one for an abdominal approach. And we have one for a laparoscopic approach. So all this does is complete the triage. It really makes no difference just so that you know which approach was used by your physician.

Get more information on the urodynamic medical coding updates, visit our medical coding training online page.