"If at any time the goal of performing a test is to acquire data that can assist in patient management, and it is medically necessary and appropriate, it is a billable service," write Jonathan Rubenstein, MD, and Mark Painter.
If you perform a bladder scan and the residual is 0 mL, can you still charge for the bladder scan?
Yes, you can bill for a bladder scan even if the residual is 0 mL—if the indication for checking the postvoid residual (PVR) was medically necessary and the results are used in patient management. If at any time the goal of performing a test is to acquire data that can assist in patient management, and it is medically necessary and appropriate, it is a billable service. For example, if a patient with a history of kidney stones has flank pain and was ordered for a renal
ultrasound, the service would be billed even if the patient ended up not having a stone. Please remember that medical necessity is the overarching criteria for billing any service, so there must be a medically necessary reason for checking the PVR. It cannot be done merely because the patient arrives in a urologist’s office.
Send coding and reimbursement questions to Rubenstein and Painter c/o Urology Times®, at email@example.com.
Questions of general interest will be chosen for publication. The information in this column is designed to be authoritative, and every effort has been made to ensure its accuracy at the time it was written. However, readers are encouraged to check with their individual carrier or private payers for updates and to confirm that this information conforms to their specific rules.