55899
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- Each claim must include ICD-10-CM diagnosis code(s) that accurately reflect the patient's condition and the reason(s) the urodynamic service was performed.
- For diagnostic urodynamic tests, report the test result if known; if results are not available at time of claim, report the symptoms that prompted the test.
- When a penile pressure cuff is used during a voiding pressure study, report CPT code 55899 and note the non-invasive urodynamic study in the narrative portion of the claim.
- When a referring/ordering physician is required, the referring/ordering physician's name and NPI must be reported on the claim.
Key Coverage Criteria
- Urodynamic testing is covered when medical necessity is documented consistent with the related Local Coverage Determination (LCD) for Urodynamics.
- Non-invasive urodynamic testing using a penile cuff (e.g., UroCuff) is indicated to evaluate male lower urinary tract symptoms (LUTS) such as urgency, frequency, nocturia, and incomplete emptying to define functional status and assist diagnosis or guide medical/surgical decision-making.
- Standard urodynamic tests (cystometry, electromyography, urethral pressure profile, uroflowmetry, voiding pressure study) are indicated to define lower urinary tract functional status and assist in diagnosis or management of urologic dysfunction.
- Non-invasive urodynamic testing using an external penile cuff (no catheter) is intended to define functional status of the lower urinary tract and to assist diagnosis or guide medical/surgical decision-making for urologic dysfunction.
- Penile cuff testing is indicated for evaluation of male lower urinary tract symptoms (LUTS) such as urgency, frequency, nocturia, and incomplete emptying to measure bladder pressure and calculate urine flow rate for diagnosis and treatment planning.
- Urodynamic testing is covered for symptomatic pelvic organ prolapse that extends beyond the hymen.
20 Active Policies
A57455 — Billing and Coding: Urodynamics
J06
L33576 — Urodynamics
J06
A58543 — Billing and Coding: Urodynamic Services - Non-invasive
J09
A58541 — Billing and Coding: Urodynamic Services - Non-invasive
J12
Related Codes
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