Billing and Coding: Urodynamics

Urodynamic services are covered when medical necessity is documented consistent with the related Local Coverage Determination (LCD). Claims must include valid ICD-10-CM diagnosis codes and required documentation (history, physical exam, test results); claims missing ICD-10 codes or sufficient medical-necessity documentation will be returned or denied. Coding must follow NCCI/OPPS edits, provide referring physician name and NPI when required, and when a penile pressure cuff is used report CPT 55899 with narrative documentation of a non-invasive urodynamic study.

"Urodynamic testing is covered when medical necessity is documented consistent with the related Local Coverage Determination (LCD) for Urodynamics."

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