Urology Coding Alert

You can code them separately - but don't expect full reimbursement for the cysto

Although urologists don't always perform cystoscopic examinations on the same day as a urodynamics study, coders are sometimes surprised to learn that the cysto is not automatically included in a complex cystometrogram (CMG).

Yes, you can code a cystoscopic examination (CPT 52000 , Cystourethroscopy [separate procedure]) on the same day as a urodynamic study. However, the complex CMG (51726, Complex cystometrogram [e.g., calibrated electronic equipment]) has more RVUs assigned to it in the Physicians Fee Schedule . If you report 57126 on the first line of your claim and 52000 on a subsequent line, most carriers will reimburse for the complex CMG at 100 percent of your fee, and the cysto at 50 percent, says Liz Hollingshead, CMC, patient accounts coordinator at Conrad Urology in Marysville, Ohio.
 
You may have the same diagnosis for both or different depending on the clinical circumstances. At times, a cystoscopic exam will be performed at another sitting, not to distort the urodynamics by the irritation of the bladder that may occasionally occur after the cysto.