Urology Coding and Reimbursement Podcast

December 1, 2021

Mark, Ray, and Scott discuss a correction to the preliminary analysis of the 2022 payment changes to the ASC payment for Urolift.  They also discuss the final agenda of the upcoming 2022 Urology Advanced Coding and Reimbursement Seminar (December 3rd - 4th, 2021 Las Vegas and January 28th - 29th, 2022 in New Orleans)

Urology Advanced Coding and Reimbursement Seminar

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Live In-Person Events

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Las Vegas, December 3-4, 2021
New Orleans, January 28-29, 2022 

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 

November 15, 2021

Mark, Ray, and Scott discuss some E&M 2021 FAQs.

Is pyuria and hematuria 2 points or one?

 If it appears to be clearing, would it still be considered “with exacerbation”?

Can a problem be considered chronic if you expect the problem will last >1 year or it is only considered chronic if the problem has existed for >1 year? 

If Medicare does not cover Bladder Scans for UTI would we count it

If the provider documents that he reviewed "records from the ER" then lists out imaging and documents a brief over view of what happened at the ER. Does this still count as 2 data points? Or would this be double dipping on the record review from the same entity?

Cystoscopy are they counted as minor surgery or just data point

Please explain what you meant when you said each cpt counts as one point

Urology Advanced Coding and Reimbursement Seminar

REGISTRATION OPEN

Live In-Person Events

Information and Registration

Las Vegas, December 3-4, 2021
New Orleans, January 28-29, 2022 

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 

October 22, 2021

Mark presents the preliminary summary of the newly released CMS 2022 Final Rule

Urology Advanced Coding and Reimbursement Seminar

REGISTRATION OPEN

Live In-Person Events

Information and Registration

Las Vegas, December 3-4, 2021
New Orleans, January 28-29, 2022 

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 

October 22, 2021

Mark, Ray, and Scott discuss the PHE, telehealth place of service update, and urology Coding Month finale.

Free E&M Training - 4 Sessions (30 minutes each)

Session #1 - Why E&M 2021 is So Important [10/25/21 at 3-3:30 pm EST]
Session #2 - Medical Decision Making 2.0: Problem, Risk and Data [10/27/21 at 2-2:30 pm EST]
Session #3 - Time, Shortcut Tools, and Best Practices [10/28/21 at 1-1:30 pm EST]
Session #4 - Case Study [#1 of 22]: Elective Sterilization (Vasectomy) [10/29/21 at 12-12:30 pm EST]

Register Now

Urology Residents

Coding and Documentation for Urology Residents

More Information and Registration

Urology Advanced Coding and Reimbursement Seminar

REGISTRATION OPEN

Live In-Person Events

Information and Registration

Las Vegas, December 3-4, 2021
New Orleans, January 28-29, 2022 

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 

October 15, 2021

Mark, Ray, and Scott revisit a question from Episode 068 about an Implantable Penile Prosthesis. Also, they discuss several additional IPP questions.  Finally, they had a question about PTNS that sparked an "Incident To" clarification discussion.

Free E&M Training - 4 Sessions (30 minutes each)

Session #1 - Why E&M 2021 is So Important [10/25/21 at 3-3:30 pm EST]
Session #2 - Medical Decision Making 2.0: Problem, Risk and Data [10/27/21 at 2-2:30 pm EST]
Session #3 - Time, Shortcut Tools, and Best Practices [10/28/21 at 1-1:30 pm EST]
Session #4 - Case Study [#1 of 22]: Elective Sterilization (Vasectomy) [10/29/21 at 12-12:30 pm EST]

Register Now

Urology Residents

Coding and Documentation for Urology Residents

More Information and Registration

Urology Advanced Coding and Reimbursement Seminar

REGISTRATION OPEN

Live In-Person Events

Information and Registration

Las Vegas, December 3-4, 2021
New Orleans, January 28-29, 2022 

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 

October 12, 2021

Mark, Ray, and Scott discuss the new Urology CPT and ICD-10 Codes.

Urology Residents

Coding and Documentation for Urology Residents

More Information and Registration

Urology Advanced Coding and Reimbursement Seminar

REGISTRATION OPEN

Live In-Person Events

Information and Registration

Las Vegas, December 3-4, 2021
New Orleans, January 28-29, 2022 

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 

October 1, 2021

Ray, Mark, and Scott discuss the global surgical package and the global days. Understanding these concepts is critical to understanding the basics of coding.

Urology Residents

Coding and Documentation for Urology Residents

More Information and Registration

Urology Advanced Coding and Reimbursement Seminar

REGISTRATION OPEN

Live In-Person Events

Information and Registration

Las Vegas, December 3-4, 2021
New Orleans, January 28-29, 2022 

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 

September 28, 2021

Ray, Mark, and Scott discuss the question: Should Urologists/APPs do their own coding?  This was a recent topic in the monthly webinar for PRS Network customers that we also wanted to share with the podcast listeners.

50% discount on all Urology Coding Courses

Register now

Urology Coding Course for Urologists and APPs
Urology Coding Course for Coders / Billers and Admins.

Special Offer Ends 10/1/21

Urology Residents

Coding and Documentation for Urology Residents

More Information and Registration

Urology Advanced Coding and Reimbursement Seminar

REGISTRATION OPEN

Live In-Person Events

Information and Registration

Las Vegas, December 3-4, 2021
New Orleans, January 28-29, 2022

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 

September 21, 2021

Mark and Scott discuss questions from the Urology Coding and Reimbursement Group 

Question 1 (:55)

I received a denial from local HMO insurance company for 52310-58 stating the benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. 
The patient on 8/11 had an obstructing ureteral stone and was stented pushing the stone back into the kidney billed 52330 and 52332.
On 8/19 the patient had ESWL billed 50590.
8/24 billed 52310-58 in office.
I contacted the insurance company and this was their response. 
 After reviewing all the claims it appears that claim for DOS 8/24/21 processed correctly as billed. In order for a claim to pay during the global period it must be separate and identifiable from the global service, and billed with the appropriate modifier showing it is separate and identifiable. The documentation submitted must also show it is not related to the global procedure performed. The providers office should be utilizing the appropriate modifiers during a global period showing it is a distinct procedural service. This information is also available on the CMS website. CMS also details which modifier to utilize for reporting removal of multiple stones. 
Any suggestions on how to proceed?
Thank you 
Joan

Question 2 (9:20)

A) Please help me code this! Patient already had the procedure and there is a pending auth. that won't be approved until I send them the code(s). Thanks!!!
Revision of IPP including cystotomy removal & replacement of IPP Reservoir.

b) How do I code this scenario?
IPP Reservoir eroded into patient's bladder, Dr. Removes the foreign body in the bladder and replaces the 1 component of the IPP. Any help would be greatly appreciated!!! Thanks! Ethel

Question 3 (14:30)

For Pediatric Urology practice, what is the difference between CPT codes 54300 and 54304 as the allowed dx codes are the same for both and the service is for chordee, not hypospadias.  Thank you!

Question 4 (17:55)

I have a question about the QW modifier. We are billing 85014 which is on the CMS CLIA waived test list. Should we only bill 85014 with the QW to Medicare or does this apply to commercial insurances too? 

Question 5 (19:25)

We recently started drawing blood to send for BRAC analysis testing for our Prostate Cancer patients.  I'm thinking the CPT code to use is 36415 but when I look on the CMS website there is no fee and the status is X.
Can we bill a nurse visit for this and is there a DX code besides C61, prostate cancer, that we should be using for the blood draw?  It may not be a lot of money but we are buying the supplies and taking up a nurse's time to do this, shouldn't we be reimbursed?

Thank you, 
Joanna

50% discount on all Urology Coding Courses

Register now

Urology Coding Course for Urologists and APPs 

 Urology Coding Course for Coders / Billers and Admins.

Special Offer Ends 10/1/21

What is your Urology Coding Score?

Click Here to Take the Free Quiz Now

Urology Advanced Coding and Reimbursement Seminar

REGISTRATION OPEN

Live In-Person Events

Information and Registration

Las Vegas, December 3-4, 2021
New Orleans, January 28-29, 2022

Monthly Webina

September 7, 2021

Ray, Mark, and Scott discuss Ray's quest of helping Urology be the best coding specialty.  They discuss the free Urology Coding Score Quiz and how it can help identify your coding needs.

Click Here to Take the Free Quiz Now

PRS Network has declared October as "Urology Coding Month" and is offering a 50% discount to the Urology Coding Course for Urologists and APPs and the Urology Coding Course for Coders / Billers and Admins.

Urology Advanced Coding and Reimbursement Seminar

REGISTRATION OPEN

Live In-Person Events

Information and Registration

Las Vegas, December 3-4, 2021
New Orleans, January 28-29, 2022

Monthly Webinar Recording

Recording of the 2022 CMS Proposed Rules and the Impact on Urology Practices webinar is now available.

Go here to view the recording and slides now...

Recording/Slides

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