decisionhealth Newsletters, Coder Pink Sheets - 2010 Issue 10 (October)
Urology RoundUp: Anorectal manometry for incontinence, anal spasm
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Article Overview
This article addresses a reader question about diagnosis codes associated with anorectal manometry testing in the office and discusses how Medicare contractor guidance and CPT commentary relate to coverage and reporting. It is intended for coding professionals and billing staff working with urology, colorectal, or pelvic floor diagnostic services, and it highlights the broader issues of payer acceptance, physician involvement, and bundled testing in the setting of manometry, sphincter EMG, and biofeedback.
Why This Topic Matters
It helps readers understand how payer policy and CPT guidance intersect for anorectal and sphincter-function testing, which can affect whether services are reimbursed and how they are reported.
Article Sections
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Question
A reader asks about office-based anal manometry testing and payer acceptance of diagnosis coding for related claims.
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Answer
The response reviews Medicare contractor guidance, CPT commentary, and physician participation requirements as they relate to anorectal testing and related services.
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Official resources
The article closes with references to Medicare and contractor resources plus a CPT Assistant citation.
What You Will Learn
- How the article frames a payer-coverage question for anorectal manometry services.
- What types of Medicare contractor and CPT resources are referenced for this topic.
- Why physician involvement and bundled service considerations matter for these tests.
- The general relationship among anorectal manometry, sphincter EMG, and biofeedback services.
Who Should Read This
- Medical coders
- Billing staff
- Urology practice administrators
- Colorectal and pelvic floor practice staff
- Compliance and reimbursement professionals
Codes Discussed
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