August 1, 2025 

In this episode, Scott, Mark, and Ray answer coding questions submitted through the PRS Helpdesk. 

1. Pay er: Anthem BCBS
   State: NV
   Code/Codes: Tranurethral resection of bladder clot that was organized to facilitate removal
   Catagory: Other
2. Question: I'm looking for a CPT code for : transurethral resection of bladder clot that was organized t facilitate removal Pt was inpt and Dr tried to do a clot removal from the bladder, but was unsuccessful as the whole bladder was the clot. So he used a resectoscope to resect the clot into smaller pieces and then removed them with a ridid biopsy forceps. This procedure took over 2 hours. I need help with a CPT code that will accurately describe this procedure
3. Payer: N/A
   State: TX
   Code/Codes: N/A
   Catagory: Other
4. Question: Do you have info or prior podcast on billing for updated h/p prior to surgery if prior h/p done greater than 30 days before surgery? Appreciate help or directions to podcast if available. Sincerely, Irene McAleer, MD,JD,MBA [email protected] 948-610-9449 Sent from my iPhone
5. Payer: Mix
   State: Ohio
   Code/Codes: 57 vs. 25 modifier
   Catagory: Other
6. Question: When is best to use 25 vs. 57 same day procedure/OR - I thought anything requiring anesthesia would be OR procedure? Cysto/stent, cysto clot evaluation, etc would be 57 but is 25 more appropriate even if done in the OR?

PRS Coding and Reimbursement Hub

Access the Hub

Free Kidney Stone Coding Calculator

Download Now

PRS Coding Courses

For Urologist

For APPs

For Coders, Billers, and Admins

PRS Billing and Other Services - Book a Call with Mark Painter or 
Marianne Desciose

Click Here to Get More Information and Request a Quote

Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

         https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

   The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/ 

© 2025 Physician Reimbursement Systems, Inc.