Billing and Coding: Transurethral Waterjet Ablation of the Prostate

Coverage for transurethral waterjet ablation of the prostate is determined by clinical criteria in LCD L38712; the procedure is covered only when reasonable and necessary per that LCD. Billing must not represent non-covered services as covered (use appropriate modifiers for non-covered services), and detailed, legible medical record documentation supporting ICD-10-CM and CPT/HCPCS coding—including provider signature and patient identifiers—must be maintained and available to the contractor.

"Transurethral waterjet ablation of the prostate is covered only when it is reasonable and necessary and the patient meets the clinical criteria specified in Local Coverage Determination (LCD) L38712."

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