Urology Revenue Cycle Management Services
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ICD-10 Urology Superbill Example
| Appointment Date & Time: | Last Seen Date: | ||||
| Patient: | Gender: | DOB: | MR# | Pat Due: | INS Due: |
| Address: | Reason: | ||||
| Home Phone: | Cell Phone: | E-Mail: | |||
| Case Name: | Case No: | Case Type: | Case Date: | ||
| Pr Insurance: | Member ID: | Co-Pay Amount: | Deductible: | ||
| Rendering Provider: | PCP: | Referring Provider: | |||
| CPT CODES | |||||
| CPT CODE | Description | CPT CODE | Description | CPT CODE | Description |
| 99203 | Consult | 51741 | Uroflow | 89264 | Sperm identification from testis tissue, fresh or cryopreserved |
| 99213 | Follow Up Visit | 51725 | Simple Cystometrogram | 89300 | Semen analysis; presence and/or motility of sperm including Huhner test (post coital) |
| 52000 | Cystoscopy | 51726 | Complex Cystometrogram | 89310 | Semen analysis; motility and count (not including Huhner test) |
| 76872 | Prostate Ultrasound | 51702 | Foley Catheter Insertion | 89320 | Semen analysis; volume, count, motility and differential |
| 81000 | Urinalysis | 52310 | Cystoscopy w/ Stent Removal | 89321 | Semen analysis; sperm presence and motility of sperm, if performed |
| 55700 | Prostate Biopsy | 51798 | Post‐Voiding Residual | 89322 | Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) |
| ICD CODES | |||||
| ICD-10 | Description | ICD-10 | Description | ICD-10 | Description |
| C61 | Malignant neoplasm of prostate | R35.0 | Frequency of micturition | N35.114 | Postinfective anterior urethral stricture, not elsewhere classified |
| N40.1 | Enlarged prostate with lower urinary tract symptoms (LUTS) | N39.0 | Urinary tract infection, site not specified | N35.119 | Postinfective urethral stricture, not elsewhere classified, male, unspecified |
| N13.8 | Other obstructive and re ux uropathy | N30.00 | Acute cystitis without hematuria | N35.12 | Postinfective urethral stricture, not elsewhere classified, female |
| R33.9 | Retention of urine, unspecified | N30.01 | Acute cystitis with hematuria | N35.8 | Other urethral stricture, unspecified |
| R33.0 | Drug induced retention of urine | N30.10 | Interstitial cystitis (chronic) without hematuria | N40.0 | Enlarged prostate without lower urinary tract symptoms (LUTS) |
| R33.8 | Other retention of urine | N30.11 | Interstitial cystitis (chronic) with hematuria | N13.30 | Unspecified hydronephrosis |
| N20.0 | Calculus of kidney | N30.20 | Other chronic cystitis without hematuria | N13.1 | Hydronephrosis with ureteral stricture, not elsewhere classified |
| N20.9 | Urinary calculus, unspecified | N30.21 | Other chronic cystitis with hematuria | N13.2 | Hydronephrosis with renal and ureteral calculus obstruction |
| N20.2 | Calculus of kidney and ureter | N30.30 | Trigonitis without hematuria | N13.39 | Other hydronephrosis |
| R97.2 | Elevated prostate speci c antigen (PSA) | N30.31 | Trigonitis with hematuria | N43.3 | Hydrocele, unspecified |
| N39.41 | Urge incontinence | N30.40 | Irradiation cystitis without hematuria | N43.0 | Encysted hydrocele |
| N43.40 | Spermatocele of epididymis, unspecified | N30.41 | Irradiation cystitis with hematuria | N43.1 | Infected hydrocele |
| N43.41 | Spermatocele of epididymis, single | N30.80 | Other cystitis without hematuria | N43.2 | Other hydrocele |
| N43.42 | Spermatocele of epididymis, multiple | N30.81 | Other cystitis with hematuria | N18.9 | Chronic kidney disease, unspecified |
| N31.9 | Neuromuscular dysfunction of bladder, unspecified | N30.90 | Cystitis, unspecified without hematuria | N18.1 | Chronic kidney disease, stage 1 |
| N31.0 | Uninhibited neuropathic bladder, not elsewhere classified | N30.91 | Cystitis, unspecified with hematuria | N18.2 | Chronic kidney disease, stage 2 (mild) |
| N31.1 | Re ux neuropathic bladder, not elsewhere classified | N15.9 | Renal tubule-interstitial disease, unspecified | N18.3 | Chronic kidney disease, stage 3 (moderate) |
| N31.2 | Flaccid neuropathic bladder, not elsewhere classified | N34.1 | Nonspecific urehtritis | N18.4 | Chronic kidney disease, stage 4 (severe) |
| N31.8 | Other neuromuscular dysfunction of bladder | N34.2 | Other urethritis | N18.5 | Chronic kidney disease, stage 5 |
| C67.9 | Malignant neoplasm of bladder, unspecified | N39.3 | Stress incontinence (female) (male) | N18.6 | End stage renal disease |
| C67.0 | Malignant neoplasm of trigone of bladder | N35.9 | Urethral stricture, unspecified | R35.1 | Nocturia |
| C67.1 | Malignant neoplasm of dome of bladder | N35.010 | Post-traumatic urethral stricture, male, meatal | R32 | Unspecified urinary incontinence |
| C67.2 | Malignant neoplasm of lateral wall of bladder | N35.011 | Post-traumatic bulbous urethral stricture | R39.81 | Functional urinary incontinence |
| C67.3 | Malignant neoplasm of anterior wall of bladder | N35.012 | Post-traumatic membranous urethral stricture | F98.0 | Non-organic origin |
| C67.4 | Malignant neoplasm of posterior wall of bladder | N35.013 | Post-traumatic anterior urethral stricture | N39.3 | Stress incontinence (female) (male) |
| C67.5 | Malignant neoplasm of bladder neck | N35.014 | Post-traumatic urethral stricture, male, unspecified | N39.41 | Urge incontinence |
| C67.6 | Malignant neoplasm of ureteric ori ce | N35.021 | Urethral stricture due to childbirth | N39.42 | Incontinence without sensory awareness |
| C67.7 | Malignant neoplasm of urachus | N35.028 | Other post-traumatic urethral stricture, female | N39.43 | Post-void dribbling |
| C67.8 | Malignant neoplasm of overlapping sites of bladder | N35.111 | Postinfective urethral stricture, not elsewhere classified, male, meatal | N39.44 | Noctural enuresis |
| N20.1 | Calculus of ureter | N35.112 | Postinfective bulbous urethral stricture, not elsewhere classified | N39.45 | Continuous leakage |
| N20.2 | Calculus of kidney with calculus of ureter | N35.113 | Postinfective membranous urethral stricture, not elsewhere classified | N39.46 | Mixed incontinence |
| Charges: | CASH | Doctor’s Signature | |||
| Payments: | CHECK: | ||||
| MC | AMX | ||||
| Balance: | VISA | DEBT | |||
| Credit Card# | |||||