Urology Coding Alert

 A May 9 CMS Program Memorandum increases the reimbursement for two common urology procedures, bladder sonography, CPT 51798 (Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging), and water-induced thermotherapy, 53853 (Transurethral destruction of prostate tissue; by water-induced thermotherapy). The new nonfacility Physician Expense (PE) Relative Value Unit (RVU) for 51798 is 0.58 (about $21.33), the new facility PE RVU for 53853 is 3.67 (about $135), and the new nonfacility PE RVU is 38.96 (about $1,433.14). Expect Medicare carriers to implement these revisions July 1.

   At the annual meeting of the American Urological Association, the organization revealed its policy on reporting code 51798 for bladder sonography: If the intent of a bladder sonogram is to measure residual urine, report 51798 regardless of the equipment used, both imaging and nonimaging. As for 76775 (Ultrasound, retroperitoneal [e.g., renal, aorta, nodes], B-scan and/or real time with image documentation; limited) and 76857 (Ultrasound, pelvic [nonobstetric], B-scan and or real time with image documentation; limited or follow-up [e.g., for follicles]), the AUA advocates reporting these codes if the urologist performs a bladder sonogram to study bladder anatomy, architecture, morphology, thickness of the wall, bladder diverticula, bladder filing defects, etc., in addition to a post-void residual determination.