51729 is a complex cystometrogram with voiding pressure studies and urethral pressure profile studies. You should not bill a 51726 with this, as it is a complex cystometrogram and is part of 51729. The denials are correct. Here are the lay descriptions of the urodynamic studies:
A cystometrogram (a graphic record of urinary bladder pressure at different volumes) is used to distinguish bladder outlet obstruction from other voiding dysfunctions. For a simple cystometrogram (51725), the physician inserts a pressure catheter into the bladder and connects it to a manometer line filled with fluid to measure pressure and flow in the lower urinary tract. For a complex cystometrogram (51726), the physician typically uses a transurethral catheter to fill the bladder with water or gas while simultaneously obtaining rectal pressure. As the bladder is being filled, intravesical pressure is measured by a microtip transducer or fluid-filled catheter attached to the transducer. Code 51727 reports a complex cystometrogram performed in conjunction with a study for measuring urethral pressure. In one technique, the bladder is filled with fluid and the catheter withdrawn into the urethra while bladder sensations and volume are recorded. Urethral pressure changes are recorded as the patient follows specific instructions (Valsalva maneuver, cough). For voiding pressure studies performed in conjunction with a complex cystometrogram (51728), a transducer is placed into the bladder and the bladder is filled with fluid. The patient is instructed to attempt to void upon the feeling of bladder fullness, and recordings are taken of bladder sensation and volume at specific times. Report 51729 if complex cystometrogram is combined with both voiding pressure studies and urethral pressure profile studies. (Ingenix Coder's Desk Reference, 2010)
Hope this helps.
Lucinda (Cindy) McGarry, CPC-P
Avera Health Plans
Education Office Sioux Falls SD Local Chapter
Past President Sioux Falls SD Local Chapter