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Urology medical billing can be riddled with complications when billing charges for various encounters.

The ongoing changes in the healthcare environment have necessitated that a billing team have dedicated and prompt follow through on denials and no claim responses. The range of patient care issues provided by Urology is wide and varied. Even though our focus is on medical billing and accounts receivable management, our broad experience across the entire Revenue Cycle Management process in a Urology practice is why we can give you an advantage compared to in-house billing.

Our team at Etransmedia has the knowledge and skills necessary to successfully work denials and provide our Urology clients with valuable feedback to assist in managing and decreasing the most frequently seen denial types, while streamlining revenue and increasing your practice’s collection rates. Getting you paid fast!

What we know…

Urology combines both a surgical and primary care practice into one and allows for the billing of a large number of services. Your billing company or office should be well educated in CPT, ICD-10 codes and modifiers in order to minimize claim errors and maximize reimbursements.

The Urodynamics codes she primarily uses for the diagnosis of Mixed Incontinence (ICD-10 code N39.46)

51741: Complex Uroflowmetry (e.g., calibrated electronic equipment)

51729: Complex Cystometrogram with voiding pressure studies, (i.e., bladder voiding pressure) and urethral pressure profile studies,(i.e., urethral closure pressure profile), Any technique.  (Note:now includes measurement of urethral pressure and bladder voiding/ flow pressure).

51784: Electromyography Studies (EMG) of anal or urethral sphincter, other than needle, any technique.

51785: Needle Electromyography Studies, (EMG) of anal or urethral sphincter, other than needle, any technique.

+51797: Voiding Pressure Studies, intra-abdominal, (i.e., rectal, gastric, intraperitoneal) (List separately in addition to primary procedure)   Note: for the abdominal pressure (whether measured rectally or vaginally)

If no urethral pressure is performed but bladder voiding/ flow pressure is performed, use code 51728 instead of using 51729

If no bladder voiding/ flow pressure is performed, but urethral pressure is performed, use code 51727 instead of using 51729

If no bladder voiding/ flow pressure is performed or urethral pressure is performed, use code 51726 instead of using 51729

(NOTE: the add-on code +51797 would not be reported with 51726 or 51727 as this code can only be reported if a pressure-flow voiding study is performed as with codes 51728 and 51729).

If a physician performs more than one urodynamic procedure on the same patient on the same day, Medicare will pay as follows: the primary procedure (billed first) at 100% of the RBRVS fee; the second through the fifth procedures will be paid at 50% of the RBRVS fee. Procedures after the fifth require carrier review to determine payment.

Documentation for Urodynamics Testing:

A separate report and interpretation should be provided for each of the services performed as part of the urodynamics study. The CPT code describing the test(s) performed in the urodynamics study with the highest RVU should be reported first. All other CPT codes should be reported with modifier 51 (if required by carrier). Medicare does not require a -51 modifier; but Medicaid requires it’s use. Additionally, all printed components of the testing of urodynamics from the calibrated equipment, etc. should be included in the patient’s chart as supporting documentation for the technical component.(This will allow billing of the technical component). The report should include the results of the tests and the interpretation of the provider in order to bill the professional component of the CPT code.

On October 1, 2016 the Centers for Medicare and Medicaid Services (CMS) will no longer accept unspecified codes in most cases. 

Starting in October, CMS requires greater specificity for claims filed in ICD-10-CM/PCS. The 12-month grace period originally introduced in 2015 said they would not deny claims for lack of ICD-10 specificity. That all changes on October 1, 2016. Payors will most likely follow suit if they haven't already.


First Pass Clean Claim Rate


Boost in Revenue*


Reduction in Cost*

Amazing Result

We’re always on top of all the latest coding and billing updates for Urology practices. Additionally, to make sure all claims are reimbursed on the first claim submission, our system is able to pre-edit claims prior to the initial submission for possible billing/coding errors. Our detailed end of month reports keep our clients up-to-date on what is happening in their practice so any issues can be addressed quickly. Having an experienced medical billing team, with visibility into performance, is vital to your practice’s financial health.

Although the new industry standards can be confusing and difficult to navigate, our dedicated team here at Etransmedia can assist in guiding you and helping to make your practice grow successfully.

*Please Note: Results are not guaranteed, implicitly or explicitly, and will vary based on several factors such as individual practice demographics, specialty, payer mix, operations, and management among others

Service and Technology Packages

Our customizable revenue cycle management service and technology solution packages allow you to outsource based on the specific needs of your practice


Silver RCM Service

This package has the core service and technology needed for revenue management allowing you maintain the responsibility of patient billing.


Gold RCM Service

This package includes the core RCM services with added denials, A/R management services, and full service patient billing


Ancillary RCM Services & Technology

Available to enhance any package


Improve your revenue by letting our services handle your revenue cycle process


Full-featured solution packages customized to focus on what your practice needs


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Connect2Care® is a turnkey solution that improves workflow and financial results.

The group at Etransmedia has handled my billing and managed my contracts for more than a decade. They are trustworthy … Read More >
- Stephen Lutz MD

President, Eastern Woods Radiation Oncology

When my former billing company decided to close abruptly, I contacted Etransmedia to help me set up my own business… Read More >
- Ann Aring, MD, FAAFP

Assoc Program Director, Riverside Family Practice Residency Program

Just a note to say ‘thanks’ – having Etransmedia handle the billing was one of the best decisions this Board has ever made … Read More >
- Paul Hardick

Cumberland Valley Counseling Associates

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