subject: Urodynamics coding: The right way to report +51797 [print this page] Urodynamics coding: The right way to report +51797
With CPT 2010, your urodynamics coding has gone for a toss. If you're finding it confusing when coding for +51797 in particular, you are not alone. In fact, if you know what to report with +51797 in particular, you can save on $138 per claim.
Can you report this code alone?
No. You cannot report +51797 alone. This code is an add-on code, which means you should never report +51797 without listing a primary procedure.
Last year, one could use this code only with 51795, but this year CPT deleted 51795. As such, the directive indication which codes you can use with +51797 changed. This year, you can go for +51797 with 51728 or 51729.
Should you add a funny symbol before +51797?
As +51797 is an add-on code, you'll often see the plus sign (+) in front of it to show that you can't report this code on its own. This sign can be seen in the CPT manual as well as in many textual references. You can do without adding the plus sign on your claim form when submitting t+51797 to payers.
What if you are coding right but still getting denials?
There have been some problems in getting reimbursed for CPT code 51797 by several carriers including some Medicare carriers. "+51797, properly coded in addition to 51728 or 51729, has been denied payment notwithstanding the fact that this coding has been spot on. The problem is that these carriers haven't updated their programs with the 2010 changes for billing urodynamics studies and don't appreciate that +51797 should be billed with CPT codes 51728 or 51729.
If you are receiving denials on +51797, however you think you are reporting the code properly, talk to your payer rep.
To do away with all the confusions surrounding +51797 and to get access to the entire CPT code list, sign up for a one-stop medical coding website.
