Urodynamics

Medicare covers urodynamic studies only when medically necessary after an initial evaluation (history, physical, urinalysis with microscopy) and when testing is needed to resolve diagnostic uncertainty, evaluate failure of therapy, guide surgical decisions, or assess specific comorbid conditions (e.g., recurrent UTI, difficult bladder emptying, prior pelvic surgery, prostate abnormalities, neurologic disease). Testing must be limited to procedures necessary to evaluate the documented signs and symptoms and is not payable for routine screening, for pelvic prolapse without urinary symptoms, or for home-recorded flow rates; providers must document clinical indications and treat active infection before testing.

"Urodynamic testing is covered when medically necessary to assist in diagnosing urologic dysfunction after an initial evaluation including history, physical exam, and urinalysis with microscopy has ..."