Urology Coding Alert

Most urinary incontinence or retention codes are acceptable - but check your LCD

All of your knowledge of urodynamics procedure coding - not to mention your practice's investment in urodynamics equipment - will count for naught if you can't show medical necessity through diagnosis coding.

ICD-9 Code listings for urodynamics include a wide range of acceptable codes. Check your carrier's local medical review policy (LMRP) or local coverage determination (LCD) for a list of payable diagnoses.

"Submit each claim with ICD-9 codes that reflect the condition of the patient and indicate the reason the urologist performed the service," says Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology at the State University of New York in Stony Brook.

Example: Empire Medicare Services, the Part B carrier for New York and New Jersey, published an LCD with over 180 ICD-9 Codes to support medical necessity for urodynamics. The LCD includes the following ICD-9 codes that urologists frequently use:
   596.51 - Hypertonicity of bladder
   596.53 - Paralysis of bladder
   600.01 - Hypertrophy (benign) of prostate with urinary obstruction
   625.6 - Stress incontinence, female
   788.1 - Dysuria
   788.20-788.29 - Retention of urine
   788.30-788.39 - Urinary incontinence
   788.41 - Urinary frequency
   788.43 - Nocturia.   Avoid using truncated diagnostic codes - don't use a four-digit code (596.5) when a five-digit code (596.51) is available, says Erin Waller, CPC, CMSCS, coder for Durham Urology in Durham, N.C.
 
Most often, one diagnosis code will suffice for all urodynamic procedures performed at one encounter,  Ferragamo says.