Urology Coding Alert

Question: Can you use the code 51725 when the urologist uses an asepto syringe, not a commercially sold manometer device?

Codify Member

Answer: No, you cannot use 51725 (Simple cystometrogram [CMG] [eg, spinal manometer]) for the procedure you describe.

Code 51725 describes a simple CMG that uses a spinal manometer to measure bladder pressures at various levels of bladder fullness. Note that if your urologist used electronic equipment for these measurements that would be represented by 51726 (Complex cystometrogram [ie, calibrated electronic equipment]).

When the urologist performs a simple CMG with a spinal manometer connected to a bladder catheter and fills the bladder using this catheter, he then measures the volume of fluid instilled and bladder pressures generated at three points during the procedure: the patient’s first urge to void, the intense urge to void, and at bladder capacity when the patient is unable to tolerate further fluid instillation. For this examination, you should use 51725.

The procedure you describe is often called an “eyeball” urodynamics and does not involve a spinal manometer. Instead the urologist catheterizes the patient, attaches an asepto syringe to the catheter, removes the irrigating bulb, holds the syringe at the bladder level (pubic bone), adds measured amounts of water or saline into the syringe, and evaluates the volume at the first desire to void, second desire to void, and bladder capacity.

Although the urologist will have some idea of the volumes instilled, he cannot determine accurate bladder pressures. However, by watching the movement of the fluid meniscus within the syringe, he can roughly estimate the bladder pressures and the presence or absence of uninhibited bladder contractions.

You should not bill this procedure with 51725. Basically the urologist is doing an instillation and, therefore, you should report 51700 (Bladder irrigation, simple, lavage and/or instillation) instead.