Billing and Coding: Fluid Jet System in the Treatment of Benign Prostatic Hyperplasia (BPH)

Coverage for the fluid jet system to treat benign prostatic hyperplasia is determined by the reasonable and necessary clinical criteria in LCD L38378; this billing article defers to that LCD for coverage decisions. Medicare billing must not be submitted for services not covered by the LCD (use appropriate modifier for non-covered services), and all claims must be supported by legible, patient-identified medical records that include provider signature and documentation justifying the chosen ICD-10-CM and CPT/HCPCS codes.

"Coverage of the fluid jet system for treatment of benign prostatic hyperplasia (BPH) is subject to the reasonable and necessary clinical criteria specified in Local Coverage Determination L38378; b..."

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