Billing and Coding: Transurethral Waterjet Ablation of the Prostate

Coverage for transurethral waterjet ablation of the prostate is determined by Local Coverage Determination L38549 and is allowed only when the LCD's reasonable and necessary criteria are met. Providers must not bill non-covered services as covered (use appropriate modifier for non-covered services) and must maintain legible medical records with patient identifiers, provider signature, and documentation supporting the selected ICD-10-CM and CPT/HCPCS codes available to the contractor.

"Transurethral waterjet ablation of the prostate is covered only when it meets the reasonable and necessary requirements specified in Local Coverage Determination L38549."

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