Urology Coding Alert

Question: Please provide a list of recommended CPT codes for biofeedback and an appropriate diagnosis code for 51741 (uroflow).

Florida Subscriber

Answer: There are two CPT code choices for biofeedback training (assuming this is not part of a psychiatric service): 90901 (biofeedback training by any modality) and 90911 (biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry). You may be performing 90911, which is described in detail in the June 1999 issue of CPT Assistant:

The service identified by code 90911 is a specific biofeedback method considered a more involved procedure than other conventional biofeedback methods (the services identified by code 90901). During anorectal/urethral biofeedback, the physician places an anal probe into the anal canal to measure anal sphincter pressure or electrical activity.

This procedure can use manometry (measure of pressure of gases or liquids by use of a manometer) or EMG (electromyography the recording of electrical activity initiated in the muscle tissue for testing purposes) to measure sphincter activity. This procedure is lengthy, taking at minimum 30 minutes, but typically lasting 45 to 60 minutes. For the patient, this procedure is very uncomfortable, particularly due to the length of time that the procedure requires. For this reason, more effort may be necessary to achieve the desired results.

As for the appropriate diagnosis code for 51741
(complex uroflowmetry [e.g., calibrated electronic equipment]), you need to follow the rationale you would whenever picking a diagnosis code. The appropriate diagnosis code for any diagnostic procedure would be the diagnosis as documented by the physician in the patients medical record. Some of the many conditions that would support the medical necessity for uroflow would be the following: 595.1 (chronic interstitial cystitis), 788.31 (urge incontinence), 625.6 (stress incontinence, female), 618.5 (prolapse of vaginal vault after hysterectomy), 596.0 (bladder neck obstruction) and 596.3 (diverticulum of bladder).

Note: See the article Payment for Biofeedback Training for Urinary Incontinence on page 3 of the December 1999 issue of Urology Coding Alert.