Currentpriority healthPolicy N/A

Bladder scans (post-void residual measurement)

Defines coding, billing, documentation, and reimbursement guidance for bladder scan (ultrasound) measurement of post-void residual urine for Priority Health members across Commercial, Medicare, and Medicaid lines where applicable.

Policy Summary

Payerpriority health

PolicyBladder scans (post-void residual measurement)

Policy CodePolicy N/A

Change TypeAdministrative (non-material)

Effective DateN/A

Next Review DateFeb 20, 2025

Key ActionDo not perform CPT 51798 more than once per day and document medical necessity, timing, performer, results and signed records.

SourceLink

POLICY UPDATE CHANGES

Added 'Disclaimer' section

CPT 51798primary code for post-void residual measurement by ultrasound

1/daymaximum times CPT 51798 should be performed

POS 11listed place of service (office)

Requireddocumentation required

No separate payfacility scans considered inclusive

Coverage and Medical Necessity

Bladder scan coverage criteria

Coverage and billing guidance for bladder scans and documentation requirements.

Coverage for bladder scan (post-void residual measurement) is subject to the following requirements and limitations:

ALL of the following

Frequency: CPT 51798 should not be performed more than once per day.
Code characteristics: CPT 51798 is a technical component only code.
Place of service: commonly billed in the office setting (POS 11) as applicable.

ALL of the following

Policy Summary

Payerpriority health

PolicyBladder scans (post-void residual measurement)

Policy CodePolicy N/A

Change TypeAdministrative (non-material)

Effective DateN/A

Next Review DateFeb 20, 2025

Key ActionDo not perform CPT 51798 more than once per day and document medical necessity, timing, performer, results and signed records.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Coding and Frequency Limits

Post-void residual ultrasoundCPTCovered

51798

Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging

Pelvic ultrasound codes referencedCPT

76856	Pelvic ultrasound; limited
76857	Pelvic ultrasound; complete

inv-04: Frequency limit for CPT 51798 — No more than once per day.

Frequency limitCPT 51798 should not be performed more than once per day.

CodeCPT 51798 — Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging.

Technical componentThis is a technical component–only code.

Facility billing impactFor inpatient and outpatient facility services, bladder scans are considered inclusive of general charges and should not be separately payable.

Prior Authorization, Billing, and Documentation Guidance

Prior Authorization

Authorization does not guarantee payment

An authorization is not a guarantee of payment; authorization requirements and medical necessity appropriate to the procedure, diagnosis, and frequency are still required. Proper billing, coding, and documentation must be followed; failure to do so may lead to claim rejection, denial, or recovery of payment.

Authorization does not supersede coding, billing, or reimbursement requirements.
Payment integrity reviews (pre- or post-claim) may be performed; failure to document services will result in denial.

Billing Rule

Facility services: no separate facility payment for bladder scans

For inpatient and outpatient facility services, bladder scans (PVR measurements) are considered inclusive to general facility charges and should not be billed or paid separately.

Bladder scans may be performed as part of routine bladder-volume monitoring or bladder bundles, but separate facility payment is not appropriate.
See facility unbundling billing policy for additional detail.

Definitions

inv-07: Bladder scan — Definition of bladder scan using ultrasound to measure post-void residual.

DefinitionA bladder scan is a procedure that uses ultrasound technology to obtain images of the bladder and calculate the amount of urine remaining (post-void residual).

MethodNon-imaging ultrasound performed on the abdomen to measure post-void residual volume.

Use caseUsed to determine the amount of urine left in the bladder immediately post-void to guide clinical management.

Documentation noteWhen PVR measurement is the only service rendered, report CPT 51798; do not separately bill pelvic ultrasound codes for the same service.