Urology Coding Alert

Question: A patient came into the office for a bladder post void ultrasound. I billed 76705 (echography, abdominal, B-scan and/or real time with image documentation; limited [e.g., single organ, quadrant, follow-up]) with a diagnosis of 600 (hyperplasia of prostate). What can I do to get reimbursement from Medicare? It is not during a global period. Medicare states it is not medically necessary.

Texas Subscriber

Answer: Post void urine residuals and/or bladder capacity by ultrasound are reported to Medicare with HCPCS code G0050. Generally, payment is made for ICD-9 codes 788.20-788.29 (retention of urine). Other ultrasound codes, e.g., 76705, 76857 (echography, pelvic [nonobstetric], B-scan and/or real time with image documentation; limited or follow-up [eg, for follicles]), and 76775 (echography, retroperitoneal [e.g., renal, aorta, noted], B-scan and/or real time with image documentation; limited), may be reported to private payers for post-void residuals. For Medicare purposes, these codes are to be used in the diagnosis and treatment of pelvic disorders only.