Summary & Overview
CPT 51798: Bladder Ultrasound for Post-Void Residual Measurement
CPT code 51798 represents the measurement of post-voiding residual urine and/or bladder capacity using a non-imaging ultrasound device. This urodynamic procedure is widely utilized in outpatient and office settings to assess bladder function, especially in patients with urinary retention or suspected bladder dysfunction. The code is recognized by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, ensuring broad coverage for providers and patients.
This publication provides a comprehensive overview of 51798, including payer coverage, clinical context, and relevant policy updates. Readers will gain insight into the procedure's role in urology, typical sites of service, and its importance in diagnosing and managing bladder conditions. The summary also highlights associated billing practices, such as common modifiers and related CPT codes, as well as the clinical diagnoses most frequently linked to this service. Benchmarks and regulatory considerations are discussed to inform stakeholders about current trends and requirements for accurate reporting and reimbursement. The content is designed to support healthcare professionals, administrators, and policy analysts in understanding the national landscape for this urodynamic procedure.
CPT Code Overview
CPT code 51798 is used to report the measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging. This procedure is a urodynamic assessment that utilizes a portable bladder scanner to evaluate bladder function without the need for imaging. It is commonly performed in the office setting or other outpatient environments, aligning with LCD guidelines for portable scanner usage. The service is essential for monitoring urinary retention and bladder health, particularly in patients with suspected or known bladder dysfunction.
Clinical & Coding Specifications
Clinical Context
A patient presents to a urology clinic with symptoms such as urinary retention, difficulty voiding, or suspected bladder dysfunction. The provider suspects conditions like uninhibited neuropathic bladder, flaccid neuropathic bladder, neuromuscular dysfunction of the bladder, or bladder-neck obstruction. To assess bladder function, the provider performs a urodynamic procedure using a portable bladder scanner to measure post-void residual urine volume and/or bladder capacity. This is a non-imaging ultrasound procedure typically performed in an office or outpatient setting. The results help guide further management of the patient's urinary symptoms.
Coding Specifications
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Modifiers:
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26: Used when reporting only the professional component of the service (interpretation of the results). - Modifier
TC: Used when reporting only the technical component (performance of the procedure and use of equipment).
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Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
208800000X |