![]() R39.9 Unspecified symptoms and signs involving the genitourinary systemĬMS’ Final Decisions on the August 2012 Recommendations of the Hospital Outpatient Payment Panel on Supervision Levels for Select Services R39.89 Other symptoms and signs involving the genitourinary system R39.198 Other difficulties with micturition R39.14 Feeling of incomplete bladder emptying N40.1 Benign prostatic hyperplasia with lower urinary tract symptoms N39.498 Other specified urinary incontinence N39.42 Incontinence without sensory awareness N39.3 Stress incontinence (female) (male) N31.9 Neuromuscular dysfunction of bladder, unspecified N31.2 Flaccid neuropathic bladder, not elsewhere classified N31.1 Reflex neuropathic bladder, not elsewhere classified N31.0 Uninhibited neuropathic bladder, not elsewhere classified N13.9 Obstructive and reflux uropathy, unspecified ICD-10 Codes that Support Medical Necessity 51798 Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. PVR ultrasound is not considered to be medically necessary when performed for routine screening purposes or when no treatment is planned regardless of the finding.Ĭontractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. To determine actual bladder volume in patients who have incomplete bladder emptying and require frequent catheterizations to drain the bladder To assist with bladder re-training by determining the need to void based on bladder volume ![]() The use of ultrasound to determine PVR is considered medically necessary and reimbursable for the following indications: ![]() Bladder ultrasound has been introduced as an alternative, noninvasive method, to avoid the potential complications of intermittent catheterization. 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. Post-voiding residual (PVR) urine volume is the volume in the bladder immediately after the completion of voiding. Some payers will require documentation with the use of the -52 modifier.ĥ1702 Insertion of temporary indwelling bladder catheter simple (eg, Foley)ĥ1703 Insertion of temporary indwelling bladder catheter complicated (eg, altered anatomy, fractured catheter/balloon)Ĭoverage Indications, Limitations, and/or Medical Necessity In this case, if only the catheterization was performed using visualization, code 52000 should be reported with a modifier -52 (reduced services) to indicate that the full cystouretheroscopy was not performed. Report code 52000 when the criteria outlined for one of these two scenarios are met:ġ.A complete cystouretheroscopy is performed by the physician utilizing the Percuvision technology.Ģ.Medical necessity for a uretheroscopy such as a history of difficult c theterizations, abnormal anatomy, or a recent difficult catheterization. 52000– Cystourethroscopy (separate procedure) – average fee payment – $200 – $230 ![]()
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