Urology Coding and Reimbursement Podcast

May 24, 2024

Mark, Ray, and Scott welcome Dr. Una Lee and Dr. John Lin to share their thoughts about their AUA IBL presentation "The Business of Urology – What I have Learned on How to be Clinically Productive" 

Urology Advanced Coding and Reimbursement VIRTUAL SEMINAR

Register Now for the Urology Advanced Coding
and Reimbursement Virtual Seminar

Join us on July 27th, 2024, for a live Zoom meeting from 9:30 am to 1:30 pm EST, and master the latest in urology coding and reimbursement with ease.

Special Early Bird Discount Code: 24UACRVE7

Click Here for Information and Registration

PRS Billing and Other Services

Click Here to Get More Information and Request a Quote

Urology Advanced Coding and Reimbursement Seminars - In-Person Seminars

Register Now for the Urology Advanced Coding and Reimbursement Seminar

Special Early Bird code: 25UACRS732 

Click Here for Information and Registration

Event Details

Location:
Las Vegas: December 6-7, 2024, at Horseshoe
New Orleans: January 31-February 1, 2025, at Harrah's

Time: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pm

Includes: Breakfast and Lunch on both days, plus 14 AAPC CEUs

   The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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

   Join the discussion:

Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

Click Here to Start Your Free Trial of AUACodingToday.com

May 17, 2024

Mark, Ray, and Scott discuss FAQs that came into the PRS Network Community.

1. Are there payers not paying for 99459?
2. Hello, the max units for J2704 is 80.  I have searched and searched and can't figure out how to bill additional units if more than 80 units is administered.  I have tried modifier 59 and my claim was still denied. Any help would be greatly appreciated.
3. Can we bill 13 units for 87798 for UTI PCR and Rectal swab PCR?
   Would charging 87801 be better for rectal swab PCR? VS 87798

Urology Advanced Coding and Reimbursement VIRTUAL SEMINAR

Register Now for the Urology Advanced Coding
and Reimbursement Virtual Seminar

Join us on July 27th, 2024, for a live Zoom meeting from 9:30 am to 1:30 pm EST, and master the latest in urology coding and reimbursement with ease.

Special Early Bird Discount Code: 24UACRVE7

Click Here for Information and Registration

PRS Billing and Other Services

Click Here to Get More Information and Request a Quote

   The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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

   Join the discussion:

Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

Click Here to Start Your Free Trial of AUACodingToday.com

May 10, 2024

Mark and Scott discuss FAQs that came into the Urology Coding and Reimbursement Group.

1. MRI fusion biopsy update
2. Hi,
3. Can you please help us with the below questions.
4.  
   1. Pessary Insertion – does it require a physician to be onsite? What about Pessary cleaning?
   2. Urodynamics – we know that Medicare requires a physician to be onsite, does this also apply to commercial payers?
   3. Biofeedback - we know that Medicare requires a physician to be onsite, does this also apply to commercial payers?
5. Hi, a question regarding NCCI edit pls. When unbundling is not allowed between two CPT, due to an indicator "0", never billed together. If the secondary CPT has more work-RVU than primary CPT, i.e. 51705 (primary) wRVU 0.9; and 52000 (secondary) wRVU 1.53, Are there any rules that we must bill Primary 51705? VS Can we choose to bill 52000 instead, knowing that 52000 has more wRVU than 51705? Thank you,
6.  

Urology Advanced Coding and Reimbursement VIRTUAL SEMINAR

Register Now for the Urology Advanced Coding
and Reimbursement Virtual Seminar

Join us on July 27th, 2024, for a live Zoom meeting from 9:30 am to 1:30 pm EST, and master the latest in urology coding and reimbursement with ease.

Click Here for Information and Registration

PRS Billing and Other Services

Click Here to Get More Information and Request a Quote

   The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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

   Join the discussion:

Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

Click Here to Start Your Free Trial of AUACodingToday.com

April 26, 2024

Ray, Mark, and Scott discuss the upcoming AUA Annual meeting in San Antonio and what PRS plans to do there.

New Courses Available for Urologists and Urology APPs

Documentation for Reimbursement Challenge for Urologists​
Use Special Discount Code:DRC5624 and Save 36%

 ​Documentation for Coding and Reimbursement for APPs​
Use Special Discount Code: DCRA5624 and Save 36%

Certification for Urology Coders

Documentation, Coding, and Billing Certification Course for Urology Coders
Use Special Discount Code: DCBSC5624 and Save 36%

PRS Billing and Other Services

Click Here to Get More Information and Request a Quote

   The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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

   Join the discussion:

Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

Click Here to Start Your Free Trial of AUACodingToday.com

April 19, 2024

Ray, Mark, and Scott discuss the nuances of communicating with payers and clearinghouses during the post-operative global period.

New Courses Available for Urologists and Urology APPs

Documentation for Reimbursement Challenge for Urologists​
Use Special Discount Code:DRC5624 and Save 36%

 ​Documentation for Coding and Reimbursement for APPs​
Use Special Discount Code: DCRA5624 and Save 36%

Certification for Urology Coders

Documentation, Coding, and Billing Certification Course for Urology Coders
Use Special Discount Code: DCBSC5624 and Save 36%

PRS Billing and Other Services

Click Here to Get More Information and Request a Quote

   The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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

   Join the discussion:

Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

Click Here to Start Your Free Trial of AUACodingToday.com

April 12, 2024

Mark and Scott discuss questions that have come into the PRS communities:

1. Hi is there any documentation, regarding the age limit for G2211 or 99459?
   
   Our MD think that they only apply to patients over 65 years old.  Is this true or is there documentation stating we can use them on patients under 65 years old.  
2. If a patient fails a Trial of void, and a catheter is placed, would the 51700 be coded or just 51702? Should it matter if pass its fail? The service was still performed. And the 51702 is a component of the 51700.
3. What are the codes that I use for gemcitibine bladder installation in the office. I know I would use 51720 would be the cpt code but how do i bill for the medicine?
4. For Scrotoplasty, complicated (CPT 55180), Does it need to be performed with either Graft of Flap, to call for "complicated"? I am trying to differentiate between 55175 (scrotoplasty, simple) and 55180 (scrotoplasty, complicated), thank you!

New Courses Available for Urologists and Urology APPs

Documentation for Reimbursement Challenge for Urologists​
Use Special Discount Code:DRC5624 and Save 36%

 ​Documentation for Coding and Reimbursement for APPs​
Use Special Discount Code: DCRA5624 and Save 36%

Certification for Urology Coders

Documentation, Coding, and Billing Certification Course for Urology Coders
Use Special Discount Code: DCBSC5624 and Save 36%

PRS Billing and Other Services

Click Here to Get More Information and Request a Quote

   The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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

   Join the discussion:

Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

Click Here to Start Your Free Trial of AUACodingToday.com

April 5, 2024

Mark, Scott, and Ray discuss why PRS developed two new courses, one for Urologists and one for APPs

 These courses aim to tackle the challenges practices face with documentation for reimbursement and efficient use of Electronic Health Records (EHR), emphasizing the importance of a unified team approach to stay updated on coding, billing, and documentation. They also discuss the critical role of Advanced Practice Providers (APPs) in urology, their billing nuances, and the necessity of continuous education to ensure financial health and combat provider burnout. The discussion wraps up with insights into the evolving landscape of medical coding and billing, stressing on AI's role in audits and the need for precise documentation. Links to further details about the courses can be found below.

New Courses Available

Documentation for Reimbursement Challenge for Urologists​
Use Special Discount Code: DRC5624 and Save 36%  (ends 5/6/24)

 ​Documentation for Coding and Reimbursement for APPs​
Use Special Discount Code: DCRA5624 and Save 36%  (ends 5/6/24)

Certification for Urology Coders

Documentation, Coding, and Billing Certification Course for Urology Coders
Use Special Discount Code: DCBSC5624 and Save 36%  (ends 5/6/24)

PRS Billing and Other Services

Click Here to Get More Information and Request a Quote

   The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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

   Join the discussion:

Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

Click Here to Start Your Free Trial of AUACodingToday.com

March 28, 2024

Mark, Scott, and Ray welcome Dr. David J. Ellis to discuss the evolution of urology practice, leadership strategies, the role of organizations like LUGPA, AUA, and AACU, and the importance of communication and education in the field.

PRS Billing and Other Services

Click Here to Get More Information and Request a Quote

   The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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

   Join the discussion:

Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

Click Here to Start Your Free Trial of AUACodingToday.com

March 22, 2024

Mark, Scott, and Ray discuss the Change Health cyberattack, G2211 developments and questions that came into the PRS Network.

1. We have been receiving denials for our Urodynamics appointments because authorization was obtained under a provider that differs from the provider that signed off on the note day of services. For non-medicare plans (and plans that do not adhere to 100% of medicare guidelines) are we able to have a provider that is not on-site at the time of the UDS appointment sign off on the note?
2. We are a multi-specialty practice that all share one TIN. If we send an established patient to be seen by a provider that practices under a different taxonomy, can this provider then bill under a new patient encounter? For example, Urology refered to Urogynecology or if Oncology referred to Urology? Additionally, can these pts be seen by differing specialties, at different office locations on the same day?
3.  

 PRS Billing and Other Services

Click Here to Get More Information and Request a Quote

   The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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

   Join the discussion:

Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

Click Here to Start Your Free Trial of AUACodingToday.com

March 15, 2024

Mark, Scott, and Ray discuss questions that came into the PRS Network.

1. Hello,
   What is the recommendation on documentation for new code 99459? Our practice is wanting to create a template for this procedure code. I know documenting a chaperon is key. Thank you
2. Hello,
   I need help.
   I am having issues with multiple insurance companies denying diagnosis code N30.10 stating it is an invalid code. Anyone else experiencing this issue? Any indication on what the issue is?
   I looked in the ICD10 code book and it states it is a billable code.
   Thank you
3. Hi I have a coding question for peds urology.
   Can CPT 51701 be used for a urine capture for UAs? Since this is peds our payor mix does not include medicare. I was under the impression that for commerical payors 51701 cannot be used for urine capture and that it would bundle into the E/M service.
   Also, shouldn't we be able to code 81001-81003 for the UA? The provider is only coding an E/M service with 51701.
   Thanks!

 PRS Billing and Other Services

Click Here to Get More Information and Request a Quote

   The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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

   Join the discussion:

Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

Click Here to Start Your Free Trial of AUACodingToday.com