Urology Coding and Reimbursement Podcast

June 18, 2021

Ray, Mark, and Scott discuss PCNL coding.  We have been getting more questions about PCNL coding.  Mark explains PCNL coding and how you should code and bill.   Also, they have a discussion about stone coding in general and Mark gives his approach to coding stones.  What do you start with Location? Approach? Number of Stones? what's next?

OPTIMIZER SERIES PART 2

Online Course from PRS Consulting - June 24th!

Important Revenue Cycle Management (RCM) Metrics; 

How to use them to identify and fix issues

More Information and Registration

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Urology Advanced Coding and Reimbursement Seminar - 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
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June 11, 2021

Ray, Mark, and Scott welcome Dr. John Lin to discuss Medical Decision Making.  When it seems like a level 4 but MDM will only get you to a level 3, what can you do?

Question from Michael:

I'm still having a hard time with less straight forward #MDM. I had a patient with left testicular pain x 3 mos. He fell from a ladder and had back pain with radicalar pain down into his leg and likely testis. GU exam is unremarkable. UA is normal. I have ordered an MRI of the lumbar spine. The best I seem to get is a level 3, but it seems to be more complex. Thoughts and justifications?

Dr. Lin is the administrator of The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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

REGISTRATION OPEN

Urology Advanced Coding and Reimbursement Seminar - 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
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June 8, 2021

Ray, Mark, and Scott discuss the importance of physicians and other QHPs providing accurate documentation to communicate what they have done.  Since the QHP is the only one able to communicate what services were provided during the encounter.

REGISTRATION OPEN

Urology Advanced Coding and Reimbursement Seminar - 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
_____________________________________________________________________

May 28, 2021

Ray, Mark, and Scott welcome Dr. John Lin and discuss TURBT vs. Bladder fulguration and biopsy codes (52204 and 52224).  The discussion is a deep dive into what circumstances the codes are used and how to differentiate in the documentation.

They also share information about the "Bundling Matrix" on AUACodingToday.com (click for free trial)

Finally, they discuss the Urology Advanced Coding and Reimbursement Seminar - Live In-Person Events (Information and Registration)

Dr. Lin runs The Thriving Urology Practice Facebook group and this topic has generated a lot of discussions.  What does it mean if you are not within the average range?

The Thriving Urology Practice Facebook Group link to join:

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

REGISTRATION OPEN

Urology Advanced Coding and Reimbursement Seminar - 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
_____________________________________________________________________

May 21, 2021

Ray, Mark, and Scott welcome Dr. John Lin to discuss payer's letters to physicians regarding their E&M billing levels relative to their "peers".  Dr. Lin runs The Thriving Urology Practice facebook group and this topic has generated a lot of discussion.  What does it mean if you are not withing the average range.

The Thriving Urology Practice Facebook Group link to join:

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

_____________________________________________________________________

REGISTRATION OPEN

Urology Advanced Coding and Reimbursement Seminar - 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
_____________________________________________________________________

May 17, 2021

Ray, Mark, and Scott discuss clinical pathways and coding and how they impact patient care.   They also discuss why accurate coding and documentation are important parts of clinical pathways and patient care.

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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 11, 2021

Ray, Mark, and Scott discuss physician supervision, incident to, and IDTF (Independent Diagnostic Testing Facility), also answer questions from the PRS Community and the Urology Coding and Reimbursement Group

FAQs

1. [14 minutes and 01 Seconds] Our Urology group bills inpatient hospital codes when we get called in for initial visit (99221-99223).  We have always been paid without issues and I have read Medicare guidelines stating this can be billed by each specialty.  In the past few months Aetna started denying these codes stating only one doctor, regardless of specialty is allowed to bill and we were told to bill subsequent day codes.  Now, Anthem is requesting takebacks on payments of these codes dating back to 2019.  I'm looking to see if anyone else is having this issue and is this correct for the payer?
   Thank you.
   Carrie
2. [19 minutes and 50 Seconds] Is biofeedback billable service after prostate surgery during the global days?  
3. [26 minutes and 02 Seconds] I need your assistance in coding a 2 surgeon surgery.
   Summary...I shortened immensely
   My urologist performed cysto open ended stent placement in ureter. The surgery was passed to the general surgeon for robotic lap sigmoid colectomy. The general surgeon dissected the colon from the bladder.My urologist now took over and robotically closed the colovesical fistula. The surgery was passed back to the general surgeon to finish his part.
   Would I use CPT 51999? and equate it to ? CPT code. 
   The 52005 would be included correct?
   These combined 2 surgeon surgeries where my urologist performs the
   colovesical fistula closure always confuses me.
   I appreciate your help.
   Thank you,
   Linda

May 3, 2021

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

FAQs

1. [40 Seconds] Our patients bring in there own testosterone and we bill out the administration code 96372.. Is the NDC #  required to be documented? 
   (We do document j code, dx , patient provided,amount given, Lot# and expiration.)
2. [8 minutes and 57 Seconds] One of my physicians completed a TURBT of multiple bladder tumors but he never listed any size. Instead, he says "aggregate greater than 5cm." My understanding was that we cannot use this and he would need to note the largest tumor resected. Could you please provide some clarification and education so I can let the provider know how to proceed or if using the aggregate size is sufficient for billing? 
3. [11 minutes and 15 Seconds] One of our providers is using a vacuum device called Calyxo when they do cysto/litho procedures that remove the stone fragments after being lasered.  Is this something we would bill for?   52352 maybe?    As always, thanks for help.   
4. [14 minutes and 40 Seconds] What is the correct code for excision of scrotal cyst.?

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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 23, 2021

Ray and Scott discuss why you need to provide complete documentation for lab tests.  Payers are starting to focus audits and takebacks on lab test reimbursement.  Mark talks about how to document your test properly.

We receive frequent questions on Robotic procedures and the proper coding.  Mark, Ray and Scott discuss the proper coding for Robotic and laparoscopic procedures.

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 20, 2021

Ray and Scott discuss the common question from urologists "Why do I need to learn to code? I have a team that does that".  Over the years many Urologists have asked this question.  Ray shares his thoughts on how much coding urologists need to know and why they need to know it. 

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