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billing voiding trials and 51700

  1. Question billing voiding trials and 51700
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    I have been charging a 99211 for voiding trials. One of my doctors has been told that he can charge a 51700 with the 99211 even if its done by the nurse. Does your practice charge 51700 for voiding trials (not in a global period) and do you get paid for them? And can someone other than the doctor perform them. Thanks.

  2. Default
    If a pt. of ours is scheduled for a Voiding Trial and an MA, NP or M.D. performs this service then we bill CPT 51700. An E&M service is billabe w/ a modifier 25 if the provider is performing a service above and beyond the work normally done for a VT. So if the pt. is strickly coming in for a VT and no additional work is involved then I don't feel it would be appropriate to bill for an E&M service. I hope that helps....

  3. #3
    Default
    Ccaroll, there is a great document on www.trailblazerhealth.com called Documentation Requirements for CPT Code 99211. While it does not specifically mention CPT 51700, it does provide the guidelines of when 99211 can/should not be billed. In your scenario, if a patient is scheduled for a procedure, an E&M would not be billable unless it was a separtely identifiable service...only bill CPT 51700.

    Also, this code does not have a global period. Therefore, it is billable, even if the patient had another procedure done that does have a 10-90 global period.

    Zaida, CPC
    Urology Practice

  4. #4
    Default Trials and 51700
    Note that a voiding trial implies a cathether sometimes patients come in with a cath already placed in the ER -- so a modifier -52 should be applied

  5. #5
    Question
    Quote Originally Posted by ucpa17109 View Post
    If a pt. of ours is scheduled for a Voiding Trial and an MA, NP or M.D. performs this service then we bill CPT 51700. An E&M service is billabe w/ a modifier 25 if the provider is performing a service above and beyond the work normally done for a VT. So if the pt. is strickly coming in for a VT and no additional work is involved then I don't feel it would be appropriate to bill for an E&M service. I hope that helps....

    I have always been told that 51700 is for "irrigating", ie, washing out clots, debris, etc. So you're saying bill 51700 for a "voiding trial"? We are not washing or rinsing out clots or debris but simply filling the bladder up to see if the patient can void on their own or not. I dont mean to be redundant, but want to clarify before re-educating providers. Is there any documentation out there on this issue?

  6. #6
    Question
    Quote Originally Posted by rpran View Post
    I have always been told that 51700 is for "irrigating", ie, washing out clots, debris, etc. So you're saying bill 51700 for a "voiding trial"? We are not washing or rinsing out clots or debris but simply filling the bladder up to see if the patient can void on their own or not. I dont mean to be redundant, but want to clarify before re-educating providers. Is there any documentation out there on this issue?
    I am still waiting for a response. 6/22/09

  7. Default
    Quote Originally Posted by rpran View Post

    I am still waiting for a response. 6/22/09

    Please advice on a CPT code for a Voiding Trial only.
    Patient already had catheter in place.

    Thanks

  8. Default
    I checked my book from a Urology coding conference I went to and did not find anything that would answer this question directly.

    Is your MD checking voiding pressure as well? If so, we use 51795 and +51798

    51795 Voiding pressure study- Bladder voiding pressure, any technique. But this is done by placing transducer in bladder to measure urine flow rate and pressure/ then using US (51798) to see if residual urine is in the bladder.

    I also checked on www.codecorrect.com in the "coach" section.

    Advice here stated to use 51700 for simple lavage w/ codes for catheter insertion.

    UNLESS pressure is being measured and then use codes listed above.

    Hope this helps.
    Rachell Lindley, CPC
    Multispecialty Clinic Coding
    Audiology
    Rheumatology
    Internal Medicine
    General Surgery
    Family Medicine
    Cardiology
    Oncology
    OBGYN

  9. Default
    Thank you so much.
    I think the 51700 is my best choice given the scenario, they did not do a bladder scan. Basically they filled the patients bladder, removed the cath to allow the patient to void on their own, this patient was actually unable to void after coming back two hours later, they then reinserted the cath and drained the bladder, attached a new leg bag and the patient was on their way.

    So you think I would bill the 51702 and the 51700?

  10. Default
    that is what I would do
    Rachell Lindley, CPC
    Multispecialty Clinic Coding
    Audiology
    Rheumatology
    Internal Medicine
    General Surgery
    Family Medicine
    Cardiology
    Oncology
    OBGYN

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