Wiki Urology 76857

[sandujar123]

Wellcare Medicaid denied the billed 76857 because it was billed the same day as urodynamic studies (51725, 51726, 51727, 51728, 51729, 51736, 51741). According their coder the measurement of a post-voiding residual urine is often performed at the same session as urodynamic studies (51725-51741) using ultrasound. According to our policy, an appropriate code should be billed instead of 76857 (limited pelvic ultrasound). Please advise..I am new into coding and I am so confused.

 

[sctaylor]

You can not bill for a urodynamic plus an ultrasound together since the urodynamic assesses the bladder, urethra and associated nerves and muscles for function. You should only be billing for one of them. We generally just bill for the urodynamic since we are only looking at the bladder function.

Sarah CPC, CUC