Treatment Categories
Pharmaceutical / Device
Tools
UroCuff
Coding and Reimbursement
Physician Coding - Office and Outpatient
How to Properly Code for the UroCuff Medical Device
Description of the UroCuff Test
- The UroCuff test measures urine flow and pressure without requiring a catheter.
- A cuff is applied externally, making the procedure less invasive and more comfortable for the patient.
- Surface EMG may also be optionally placed (perianal and/or abdominal)
Coding Options*
Primary Coding Option:
Primary Code*: There are two options for the primary billing code, and the appropriate
code should be selected based on payer preference:
53899: This is an unlisted procedure code for the urinary system.
51728 with Modifier -52: This is used to report urodynamic studies, specifically
a CMG (Cystometrogram) without full bladder voiding pressure.
Modifier -52: Indicates a reduced service, as the full CMG is not performed.
Additional
Billing Codes: 51784: Electromyography studies (EMG) of anal or urethral sphincter, other than
needle, any technique. Bill only if the optional perianal EMG is performed.
51741*: Complex uroflowmetry (e.g. calibrated electronic equipment)
*Always verify coding and billing guidelines with your specific payer, as policies and coverage determinations can vary by insurer and are subject to change.
Post-Void Residual (PVR) Imaging following UroCuff Test
51798: Measurement of post-voiding residual urine and/or bladder capacity by
ultrasound, non-imaging.
Be cautious when billing PVR imaging as part of the UroCuff or urodynamics:
- PVR is only billable if it is medically necessary and well-documented.
- Ensure the documentation states the PVR was done without
catheterization and clearly supports the clinical need. - Denials are increasing for artificially filled bladder PVRs, especially from Aetna. Document that the PVR was done with a natural bladder fill versus an artificial fill.
Additional Support Resources
A Physician Dictation for UroCuff
Sample Publication on Equivalence to Catheterized Voiding Pressure-1
Sample Publication on Patient Management
SRS Coding Hotline
866-850-7607
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Content: The content on this site is provided for informational purposes only and reflects coding and billing guidelines based primarily on Medicare rules and regulations as they existed at the time of publication. Guidelines are subject to change. Users are responsible for confirming the most current policies with their respective payers—including Medicare—before delivering services or submitting claims.
Sponsorships: Some content or elements of this site may be sponsored. Sponsors have paid a fee for advertising placement; however, they do not control the development or maintenance of educational or editorial content.
