Advertisement

Physician Coding and Reimbursement for Urodynamics

  • David J. Osborn
  • Denise Lynn Gartin
  • W. Stuart Reynolds
  • Roger R. Dmochowski
Chapter

Abstract

In 2010, the Centers for Medicare and Medicaid Services (CMS) simplified the coding of urodynamics by eliminating several Current Procedural Terminology (CPT) codes. One effect of this was a decrease in the reimbursement for urodynamics to physicians. In addition, CMS has also placed more emphasis on pairing the urodynamic CPT codes with an appropriate International Classification of Diseases-9th Revision Clinical Modification (ICD-9-CM) code. If coded correctly, urodynamic evaluation can still be reimbursed fairly. This chapter attempts to explain the reimbursement for urodynamics, basic coding terminology and provides a step-by-step explanation of how urodynamics should be properly coded.

Keywords

Current Procedural Terminology Current Procedural Terminology Code Ambulatory Surgery Center Physician Reimbursement Facility Setting 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Hu T-W, Wagner TH, Bentkover JD, et al. Estimated economic costs of overactive bladder in the United States. Urology. 2003;61:1123–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Ingenix National Fee Analyzer 2011, Charge data for evaluating fees nationally. 2011. Eden Prairie MN. Ingenix. Cited by Smith AL, Wein AJ. Predicting the future of urodynamics. Transl Androl Urol. 2012;1(2):76–7. doi: 10.3978/j.issn.22234683.2012.06.01Google Scholar
  3. 3.
    Pickett D. International classification of diseases. 10th ed. Clinical modification ICD-10-CM. www.cdc.gov. http://www.cdc.gov/nchs/icd/icd10cm.htm. Accessed 14 Nov 2013.
  4. 4.
    Blum J, editor. Letter from director of center for medicare. http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SustainableGRatesConFact/Downloads/SGR2013-Final-Signed.pdf. Accessed 21 Aug 2013.
  5. 5.
    Ingenix. Coding companion for urology/nephrology. Optum Insight; 2012.Google Scholar
  6. 6.
    IngenixOptumInsight. Current procedural coding expert 2012. OptumInsight Incorporated; 2011.Google Scholar
  7. 7.
    Urodynamics procedures. Cooper surgical. http://www.coopersurgical.com/Documents/Urodynamic%20Reimbursement%202011.pdf. Accessed 12 Aug 2013.

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • David J. Osborn
    • 1
  • Denise Lynn Gartin
    • 1
    • 2
  • W. Stuart Reynolds
    • 1
  • Roger R. Dmochowski
    • 1
  1. 1.Department of UrologyVanderbilt University Medical CenterNashvilleUSA
  2. 2.Physician Billing ServicesVanderbilt University Medical CenterNashvilleUSA

Personalised recommendations