How To Use CPT Code 51726

CPT 51726 describes the procedure known as a complex cystometrogram, which is used to evaluate and diagnose certain urinary disorders. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 51726?

CPT 51726 is used to describe a complex cystometrogram, a procedure that measures the bladder’s capacity and evaluates its contraction and expulsion activities. This test is performed to diagnose specific urinary disorders and determine if the detrusor muscle is functioning properly. Unlike a simple cystometrogram, a complex cystometrogram involves filling the bladder through a catheter and measuring the pressures using calibrated electronic equipment.

2. Official Description

The official description of CPT code 51726 is: ‘Complex cystometrogram (i.e., calibrated electronic equipment).’ This code is used when the bladder is filled through a catheter, and the pressures are measured using calibrated electronic equipment.

3. Procedure

1. During a complex cystometrogram, a small catheter is inserted into the bladder.
2. The bladder is then filled with fluid through the catheter.
3. Calibrated electronic equipment is used to measure the pressures within the bladder.
4. The procedure evaluates the bladder’s capacity, flow, and storage pressures.
5. Abnormal detrusor sphincter contractions can also be detected during a complex cystometrogram.

4. Qualifying circumstances

A complex cystometrogram is typically performed when a patient presents with urinary symptoms or suspected urinary disorders. This procedure is used to diagnose conditions such as bladder dysfunction, neurogenic bladder, and urinary incontinence. It is important to note that a qualified healthcare professional must perform the complex cystometrogram using calibrated electronic equipment.

5. When to use CPT code 51726

CPT code 51726 should be used when a complex cystometrogram is performed using calibrated electronic equipment. This code is appropriate when the bladder is filled through a catheter, and the pressures are measured using calibrated electronic equipment. It is important to ensure that the procedure meets the specific criteria outlined in the official description.

6. Documentation requirements

To support a claim for CPT code 51726, the healthcare professional must document the following information:

• Indication for the complex cystometrogram
• Details of the procedure, including the use of calibrated electronic equipment
• Date and time of the procedure
• Results and findings from the complex cystometrogram
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 51726, it is important to ensure that the procedure meets the criteria outlined in the official description. The use of calibrated electronic equipment is essential for reporting this code. Additionally, it is important to follow any specific guidelines provided by the payer or coding guidelines. It is also important to note that CPT code 51726 should not be reported with other codes unless additional procedures, such as a urethral pressure profile or voiding pressure study, are performed.

8. Historical information

CPT code 51726 was added to the Current Procedural Terminology system on January 1, 1990. The code was later updated on January 1, 2010, with a slight change in the description. Since then, there have been no further updates or changes to the code.

9. Examples

1. A patient presents with urinary incontinence, and a complex cystometrogram is performed using calibrated electronic equipment to evaluate bladder function.
2. A patient with suspected neurogenic bladder undergoes a complex cystometrogram to assess bladder capacity and storage pressures.
3. A healthcare professional performs a complex cystometrogram on a patient with bladder dysfunction to measure the pressures within the bladder using calibrated electronic equipment.
4. A complex cystometrogram is performed on a patient with urinary symptoms to detect any abnormal detrusor sphincter contractions.
5. A patient with suspected urinary disorders undergoes a complex cystometrogram to evaluate bladder function and measure the pressures within the bladder.