Urology Coding Alert

Question: Our physicians often perform a procedure in which the patient has an indwelling Foley catheter, either post-op or due to other issues. The patient comes to the office for a voiding trial to see if the catheter can be removed. The clinical staff will use a spinal manometer and fill the bladder through the catheter. They then remove the catheter to see if the patient can void on his own. We use 51725 to report this procedure. Is this code correct? Michigan Subscriber Answer: If you are truly performing a simple cystometrogram (CMG) and are not within the global period of another procedure, then 51725 (Simple cystometrogram [e.g., spinal manometer]) is indeed the correct code for this service. How it works: The cystometrogram (51725) indicates if the detrusor muscle is functioning properly. It detects the capacity of the bladder, and abnormal detrusor sphincter contractions. If the patient's incontinence is due to stress, the cystometrogram is normal. Remember: If you are not in a global period and the urologist is only doing a bladder fill, use 51700 (Bladder irrigation, simple, lavage and/or installation) for the bladder fill. If the patient is unable to void after the filling of his bladder, and your urologist replaces a foley catheter, you cannot separately report the catheterization (51702, Insertion of temporary indwelling bladder catheter; simple [e.g., Foley]) since the CCI bundles 51702 into 51700, and you cannot undo the bundle with a modifier. In addition, 51700 pays a higher fee than 51702.