Billing and Coding: Transurethral Waterjet Ablation of the Prostate

This billing and coding article defers coverage determinations for transurethral waterjet ablation of the prostate to LCD DL38707 and requires that services meet that LCD's reasonable and necessary criteria. Providers must maintain complete, legible medical records with patient identifiers and provider signatures, ensure the record supports the selected ICD-10-CM diagnosis codes and that CPT/HCPCS codes accurately describe the service, and must not bill Medicare for services not covered by the LCD (use the appropriate modifier for non-covered services).

"Coverage for transurethral waterjet ablation of the prostate is determined by Local Coverage Determination (LCD) DL38707 and is allowed only when the LCD's reasonable and necessary requirements are..."

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