For
Private Practice
Reimbursement
for BladderScan® and FloPoint® is accomplished using the following CPT codes:
CPT
51741: Uroflowmetry, simple/complex measures
the urine flow rate visually, electronically or with
the use of a disposable unit. The flow rate reflects
the combined activity of the detrusor muscle, bladder
neck, and urethral function. Decreased flow rate may
be due to poor detrusor function from, for example,
neurologic lesions, obstructing BPH, or cystocele. Increased
flow rate may indicate poor urethral function causing,
for example, stress urinary incontinence (SUI) or intrinsic
sphincter dysfunction (ISD).
CPT
51798: Measurement of post voiding residual
urine and/or bladder capacity by ultrasound, non-imaging.
Post-void residual (PVR) urine volume is the volume
in the bladder immediately after the completion of voiding.
The standard method of determining PVR urine volumes
is intermittent catheterization, which is associated
with increased risk of urinary infection, urethral trauma
and discomfort for the patient. Bladder ultrasound has
been introduced as an alternative, noninvasive method,
to avoid the potential complications of intermittent
catheterization.
Bladder
ultrasound or bladder scan to determine post-void residual
urine employs either a standard ultrasound machine or
a portable, battery-powered ultrasound device which
consists of a hand-held ultrasound transducer (scanhead)
and a base unit with a display screen. This unit automatically
calculates and displays the bladder volume.
Common
Urologic Indicators for 2007
| CPT
51741 for Medicare
Suggested ICD-9 Codes (FloPoint®) |
| 344.61 |
Equina
syndrome with neurogenic bladder |
| 596.0 |
Bladder
neck obstruction (acquired) |
| 596.4 |
Atony
of bladder |
| 596.51 |
Hypertonicity
of bladder |
| 596.52 |
Low
bladder compliance |
| 596.53 |
Paralysis
of bladder |
| 596.54 |
Neurogenic
bladder NOS |
| 596.55 |
Detrusor
sphincter dyssynergia |
| 596.59 |
Other
functional bladder disorder |
| 598.00 |
Urethral
stricture due to unspecified infection |
| 598.1 |
Traumatic
urethral stricture |
| 598.2 |
Postoperative
urethral stricture |
| 598.8 |
Other
specified causes of urethral stricture |
| 598.9 |
Urethral
stricture, unspecified |
| 600.0 |
Hypertrophy
of prostate (BPH) |
| 788.20 |
Retention
of urine, specified |
| 788.21 |
Incomplete
bladder emptying |
| 788.29 |
Other
unspecified retention of urine |
| 788.30 |
Urinary
incontinence, unspecified |
| 788.31 |
Urge
incontinence |
| 788.32 |
Stress
incontinence, male |
| 788.33 |
Mixed
incontinence |
| 788.34 |
Incontinence
w/o sensory awareness |
| 788.35 |
Post-void
dribbling |
| 788.36 |
Nocturnal
enuresis |
| 788.37 |
Continuous
leakage |
| 788.39 |
Other
urinary incontinence |
| 788.41 |
Urinary
frequency (micturition) |
| 788.42 |
Polyuria |
| 788.43 |
Nocturia |
| 788.61 |
Splitting
of urinary stream (intermittent) |
| 788.62 |
Slowing
of urinary stream (weak) |
CPT
51798 for Medicare
Sugggested ICD-9 Codes (BladderScan®) |
| 594 |
Calculus
of lower urinary tract |
| 594.0
|
Calculus
in diverticulum of bladder |
| 594.1
|
Other
calculus in bladder |
| 594.2
|
Calculus
in urethra |
| 594.8
|
Other
lower urinary tract calculus |
| 594.9
|
Calculus
or lower urinary tract, unspecified |
| 595
|
Cystitis |
| 595.0
|
Acute
cystitis |
| 595.1 |
Chronic
interstitial cystitis |
| 595.2
|
Other
chronic cystitis |
| 595.3 |
Trigonitis
|
| 595.4
|
Cystitis
in disease classified elsewhere |
| 595.8
|
Other
specified types of cystitis |
| 595.81
|
Cystitis
cystica |
| 595.82
|
Irradiation
cystitis |
| 595.89
|
Other
|
| 595.9
|
Cystitis,
unspecified |
| 596
|
Other
disorders of the bladder |
596.0
|
Bladder
neck obstruction |
596.1
|
Intestinovesical
fistula |
596.2
|
Vesical
fistula, not elsewhere classified |
596.3
|
Diverticulum
of bladder |
596.4 |
Atony
of bladder |
596.5 |
Other
functional disorders of bladder |
596.51
|
Hypertonicity
of bladder |
596.52 |
Low
bladder compliance |
596.53
|
Paralysis
of bladder |
596.54
|
Neurogenic
bladder NOS |
596.55
|
Detrusor
sphincter dyssynergia |
596.59 |
Other
functional disorders of bladder |
596.6
|
Rupture
of bladder, nontraumatic |
596.7
|
Hemorrhage
into bladder wall |
596.8
|
Other
specified disorders of bladder |
596.9
|
Unspecified
disorders of bladder |
| 597
|
Urethritis,
non sexually transmitted, and urethral syndrome |
| 597.0
|
Urethral
abscess |
| 597.8
|
Other
Urethritis |
| 597.81
|
Urethral
syndrome, NOS |
| 598
|
Urethral
stricture |
| 598.0
|
Urethral
stricture due to infection, unspecified |
| 598.01 |
Due
to infective disease classified elsewhere |
| 598.1
|
Traumatic
urethral stricture |
| 598.2
|
Postoperative
urethral stricture |
| 598.8 |
Other
specified causes of urethral stricture |
| 598.9
|
Urethral
stricture, unspecified |
| 599
|
Other
disorders of urethra and urinary tract |
| 599.0
|
Urinary
tract infection, site not specified |
| 599.1 |
Urethral
fistula |
| 599.2 |
Urethral
diverticulum |
| 599.3 |
Urethral
caruncle |
| 599.4
|
Urethral
false passage |
| 599.5 |
Prolapse
urethral mucosa |
| 599.6 |
Urinary
obstruction, unspecified |
| 599.7
|
Hematuria
|
| 599.8
|
Other
specified disorders of urethra and urinary tract
|
| 599.81 |
Urethral
hypermobility |
| 599.82 |
Intrinsic
(urethral) sphincter deficiency ISD |
| 599.83 |
Urethral
instability |
| 599.84 |
Other
specified disorders of urethra |
| 599.89 |
Other
specified disorders of urinary tract |
| 599.90 |
Unspecified
disorders of urethra and urinary tract |
788 |
Symptoms
involving urinary system |
| 788.0 |
Renal
colic |
| 788.1
|
Dysuria
|
| 788.2 |
Retention
of urine |
| 788.2
|
Retention
of urine, unspecified |
| 788.21
|
Incomplete
bladder emptying |
| 788.29 |
Other
specified retention of urine |
| 788.30 |
Incontinence
of urine, unspecified |
| 788.31 |
Urge
incontinence |
| 788.32
|
Stress
incontinence, male |
| 788.33 |
Mixed
incontinence, (male) (female) |
| 788.34
|
Incontinence
without sensory awareness |
| 788.35 |
Post-void
dribbling |
| 788.36
|
Nocturnal
enuresis |
| 788.37 |
Continuous
leakage |
| 788.38
|
Other
urinary incontinence |
| 788.4 |
Frequency
or urination and polyuria |
| 788.41 |
Urinary
frequency |
| 788.42 |
Polyuria
|
| 788.43 |
Nocturia |
| 788.5
|
Oliguria
and anuria |
| 788.6
|
Other
abnormality of urination |
| 788.61
|
Splitting
of urinary stream |
| 788.62 |
Slowing
of urinary stream |
| 788.69 |
Other |
| 788.70 |
Urethral
discharge |
| 788.8
|
Extravasation
of urine |
| 788.9
|
Other
symptoms involving urinary system |
| 996.1 |
Mechanical
complications of other vascular device, implant
and graft |
| 996.8
|
Complications
of transplanted organ |
| 996.80
|
Transplanted
organ, unspecified |
| 996.81
|
Kidney
|
INDICATIONS
AND LIMITATIONS OF COVERAGE AND/OR MEDICAL NECESSITY:
Measurement of post-void residual urine has been performed
accurately in the past by simple catheterization, but
now is most often performed by ultrasound to avoid an
invasive procedure.
Note:
The ICD-9 codes are sample conditions with which the
BladderScan® and FloPoint® may
be be associated. Final diagnosis coding remains the
responsibility of the diagnosing physician. Specific
payer policies may articulate ICD-9 codes that support
medical necessity. Physician must consult payer policies.
The
Physician Reimbursement System phone number is 1.800.972.9298.
Any member of the AUA can use this service for free.
UROPEARLS
(requires Adobe®
Acrobat® reader)
BladderScan® Report
(requires Adobe®
Acrobat® reader)
BVI 6100
ScanPoint® Printouts (requires Adobe®
Acrobat® reader)
|
