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Does Medicare Cover Urodynamic Testing?

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By Daniel Petkevich
Dec 2, 2022

Do you meet the requirements?

Good news if you're looking for Medicare coverage of urodynamic testing. You will not have to pay the full price out-of-pocket, since Medicare offers coverage as long as you meet certain stipulations. Do you meet one of the requirements? Let's find out.

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What is urodynamic testing?

Urodynamic testing is a procedure used to measure bladder and urethra pressure while they are being filled with fluid. It helps doctors diagnose issues such as overactive bladder, incontinence, and other urinary tract problems.

What are the Medicare requirements for urodynamic testing?

Medicare coverage of urodynamic testing kicks in when when you have signs or symptoms of a urinary tract disorder, such as urgency, frequency, incontinence, retention, or obstruction. In addition, your doctor must also order the test in writing and provide clinical justification for why it's necessary. If any of the following apply, you could also qualify for a test.
  • Failure to respond to a therapeutic trial deemed adequate
  • Consideration of surgical intervention
  • Uncertain diagnosis and inability to develop a treatment plan on existing information
If you have Medicare coverage, you still might have out-of-pocket expenses based on your specific plan. You could pay up to 20% of the Medicare-approved amount on Part B. Contact your plan provider to see how much you would have to pay.

How to find a doctor who offers urodynamic testing?

If you meet the requirements for Medicare coverage of urodynamic testing, your next step is to find a provider who offers this service. Your first stop should be your primary care doctor or your urologist. If they do not offer the testing, ask them for a referral to someone in your area who does. You can also search online for providers in your area.

How to schedule an appointment for urodynamic testing

Once you find a provider that offers urodynamic testing, you can contact them directly to schedule an appointment. Many providers offer online or phone booking, so this should be relatively easy. Be sure to ask about any requirements for the appointment and what paperwork or tests you may need beforehand.

What to expect during your appointment

During your appointment, the urodynamic testing will be explained in more detail. Generally, it is a painless procedure that involves inserting a catheter into the bladder to measure pressure. Depending on your individual condition and needs, additional tests might be required during or after the appointment.
Finally, make sure to get a copy of the results from your appointment. This will include the data collected during the test, as well as any recommendations for treatment.

What are the possible results of urodynamic testing?

The results of urodynamic testing can help your doctor diagnose and treat issues such as urinary tract infections, overactive bladder, incontinence, and other bladder problems. Depending on the results of the test, your doctor may recommend lifestyle changes or medications to manage symptoms. In some cases, surgery might be recommended if the condition is serious enough.

What are the potential risks and side effects of urodynamic testing?

The risks of urodynamic testing are typically minor. Possible side effects include discomfort, infection, bleeding, and temporary urinary incontinence. Your doctor will be able to discuss the risks with you in more detail during your appointment or beforehand.

Conclusion

Medicare coverage of urodynamic testing can help you get the diagnosis and treatment you need for urinary tract disorders. You must speak with your doctor to ensure this test is right for you. This content is for informational purposes only. You can always call Fair Square Medicare for any Medicare questions you might have. Our team of experts is ready for you.

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