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A complex cystometrogram (CMG) is a specialized diagnostic procedure used to assess bladder function by measuring bladder capacity and storage pressures. This test is particularly valuable in evaluating various urological conditions, including urinary incontinence, difficulties with urination, and neurogenic bladder disorders. The procedure begins with the patient emptying their bladder, after which the volume of urine is measured. To ensure a sterile environment, the urethra is cleansed with an antiseptic solution. A sterile catheter equipped with a sensor is then carefully inserted through the urethra into the bladder. Once in place, the bladder is filled with sterile saline, and the physician engages the patient in a dialogue to gauge their sensations during the filling process, including feelings of fullness, pain, urgency, and any leakage. In the context of CPT® Code 51727, the complex CMG is performed using calibrated electronic equipment that allows for the simultaneous measurement of intra-abdominal pressure, total bladder pressure, and true detrusor pressure. The detrusor muscle is the primary muscle responsible for bladder contraction. This advanced technique enables the differentiation between involuntary detrusor contractions and changes in bladder compliance that may occur due to increased intra-abdominal pressure. Additionally, the procedure incorporates urethral pressure profile studies, which assess the urethra's ability to prevent urine leakage. A fluid-filled catheter with multiple radial lumen openings is advanced into the bladder, and saline solution is continuously perfused through the catheter as it is slowly withdrawn through the urethra. This setup allows for the recording of urethral pressures, resulting in a detailed pressure tracing that provides critical information for the physician's assessment. Following the completion of the complex CMG and any additional studies, the physician interprets the results and generates a comprehensive written report.
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The complex cystometrogram (CMG) with urethral pressure profile studies is indicated for the evaluation of various urological conditions. The following are the primary indications for performing this procedure:
The procedure for a complex cystometrogram with urethral pressure profile studies involves several detailed steps to ensure accurate measurement and assessment of bladder and urethral function. The following outlines the procedural steps:
After the complex cystometrogram and urethral pressure profile studies are completed, patients may experience some temporary discomfort or a sensation of urgency. It is important for patients to be informed about potential post-procedure symptoms, which may include mild bladder irritation or transient urinary frequency. The physician will provide specific post-procedure care instructions, which may include recommendations for hydration and monitoring for any unusual symptoms. A follow-up appointment may be scheduled to discuss the results of the procedure and any necessary further evaluations or treatments based on the findings.
| Short Descr | CYSTOMETROGRAM W/UP | Medium Descr | COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE | Long Descr | Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 200 - Nonoperative urinary system measurements |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | AG | Primary physician | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary |
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| 2010-01-01 | Added | - |
| 1984-12-31 | Deleted | Code deleted. |
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