UCR 063: FAQs; 51728 and 51729 differentiation, Criteria for 45990, F/U visit and provider did a PVR can use -25

August 10, 2021

Ray, Mark, and Scott discuss questions from the Urology Coding and Reimbursement Group 

Question 1:  49 Seconds

What documentation could I look for to differentiate 51728 and 51729. There is no clear mention of “urethral pressure  profile study” in UDS documentation.

Question 2 - minute 10:22

What are the criteria for billing 45990 - the CPT book lists "requiring" anesthesia. 
Can I bill 45990 since the DRE was done under anesthesia after a cystoureteroscopy 

Question 3 - 15:19

If patient came in for f/u visit and provider did a pvr. Should you bill E&M code with Mo-25? 

Medicare prime 



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