Urology Coding and Reimbursement Podcast

By Mark Painter, Scott Painter and Dr. Ray PainterHealth & Fitness

Urology Coding and Reimbursement Podcast episodes

April 12, 2021 UCR 046: The New Optimizer Series from PRS: Why it Was Developed and the First Part of the Series - "Optimizing Front Office and Critical Processes"
April 12, 2021

Mark, Ray, and Scott discuss the new PRS Network series: The Optimizer. Why they decided to develop the Optimizer Series and what they hope to help urology practices accomplish.
Also, they discuss part 1 of the series: Optimizing the Front Office and Critical Processes. Mark shares a story of 1 practice that lets $100,000 of uncollected AR walk through the door each month. They continue the discussion of how the series can help you focus on specific parts of your practice and optimize those functions.

Learn More about the Optimizer Series Part 1: Optimizing the Front Office and Critical Process

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
26 min
April 03, 2021 UCR 045: Modifier Rules and other data in the National Physician Fee Schedule Relative Value File; where it is in AUACodingToday and how we made it easier to understand
April 3, 2021

Mark, Ray, and Scott had a question this week on whether or not you could use the bilateral modifier (-50) for code:
54351 - Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic
You may be surprised at the answer!
This prompted the discussion on data and where it comes from and how we have interpreted it and summarized it in AUACodingToday.com. The interpretation and summarization help make coding more efficient.

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

30 min
March 26, 2021 UCR 044: Payers - using hassle factor to delay payments, what you can do
March 26, 2021

Mark, Ray, and Scott discuss a problem with United Health Care and payment delays for higher-priced claims (ie Provenge, Urolift). What options do you have? What should you do?
Share your payer stories with us
Email: [email protected]
or on the free Q&A forum Urology Coding and Reimbursement Group.

Take the 30 Day Urology Coding and Billing Challenge and learn what a coder, biller, admin and other non-QHPs should know and nothing more.

Learn More

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

23 min
March 19, 2021 UCR 043: FAQs - Bilateral Ureteroscopy Laser lithotripsy with stent; Urodynamics and Catheter; Cysto w/ sp Tube; Family history and risk; Documenting what was reviewed

March 19, 2021

Mark, Ray, and Scott discuss several questions about the new 2021 E&M rules from the Urology Coding and Reimbursement Group:
Question 1 (:55)
For bilateral Ureteroscopy Laser lithotripsy with stent placements can we bill 52353, 52332 (using N20.0 as diagnosis) & 52356 (using N20.1 as diagnosis)
Question 2 (5:35)
For Urodynamics- when patient has foley catheter in place prior to procedure and will need a foley catheter placed after the procedure can we bill for the foley catheter cpt 51702
Question 3 (9:47)
Can we bill a cystoscopy with an sp tube change at the same visit? CPT codes 52000 & 51705
Question 4 (17:00)
So in today's (3/18/21) webinar, the subject of prostate cancer screening came up and it made me think of this question. It sounded like Mark was saying we would count the family history of prostate cancer as more risk, but not as an actual problem assessed for this patient. Could I please ask for clarification on this again? Thanks
Question 5 (24:24)
Hi, looking for some clarification on the data collection/review of the new E/M guidelines. and documentation requirements .if our providers review an outside note, lab, xray etc.. they should document what was reviewed in their notes ?
I have not found anything that specifically says to document what you reviewed that I can show our providers.
any help appreciated
thanks

Take the 30 Day Urology Coding and Billing Challenge and learn what a coder, biller, admin and other non-QHPs should know and nothing more.

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Join the discussion:

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

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34 min
March 12, 2021 UCR 042: How the New Technical Revisions to E&M 2021 Guidelines Impact Urology

March 12, 2021

Ray, Mark and Scott discuss technical revisions that the AMA released March 9th, 2021. The team breaks down what's different and what urology practices need to understand.
In addition to the details, they will also give urology examples so you understand the concepts.

Link to the CPT® Evaluation and Management (E/M) Office or Other Outpatient (99202-99215) and Prolonged Services (99354, 99355, 99356, 99417) Code and Guideline Changes:

EM 2021 Guidelines Technical Corrections 3-9-21

March Edition of the Monthly Webinar Series, live March 18th, 2021 at 1 pm Eastern.

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Take the 30 Day Urology Coding and Billing Challenge and learn what a coder, biller, admin and other non-QHPs should know and nothing more. Learn More

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
50 min
March 08, 2021 UCR 041: Deductible Season: Impacts and How to Ensure Your Practice is Prepared
March 7, 2021

Ray, Mark, and Scott discuss deductibles and the impact they have on urology practices. The importance of previsit planning and training to ensure a healthy practice.

Take the 30 Day Urology Coding and Billing Challenge and learn what a coder, biller, admin, and other non-QHPs should know and nothing more.

Learn More

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
31 min
February 27, 2021 UCR 040: "Incident to" billing; When to bill the 99211- Nurse Visit

UCR 040: "Incident to" billing; When to bill the 99211- Nurse Visit

February 26, 2021

Ray, Mark and Scott discuss incident to billing and when to bill the 99211 nurse visit.

Take the 30 Day Urology Coding Challenge and learn what a QHP should know and nothing more.

Learn More

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

29 min
February 19, 2021 UCR 039: FAQs, Multiple ESWLs, 55700 with 96372, vital sign collection requirements, 99441-99443 usage, 51702 and A4344

February 19, 2021

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

Question 1: 40 Seconds

Hello, one of our physicians has been doing multiple ESWL's (cpt 50590) on the same dos for treating more than one stone..i.e one kidney stone, one ureteral stone or bilateral stones..i have found info that says only one 50590 per dos and also to unbundle with an X modifier
any clarification much appreciated
thanks

Question 2 - minute 5:03

We are seeing denials from Cigna Medicare plans where they are denying 96372 as bundled into 55700, 76872. We added a modifier of 59 to 96372 to break it out of the bundling per the AUA coding today, since we are administering an antibiotic but the the insurance plan is stating it is part of the 55700 procedure. As far as I know Medicare is not denying this. Please advise. Thanks for you help.

Question 3 - minute 15:49

How important is it to check the vital signs on every patient for every office encounter? I understand the medical necessity and utility of it occasionally but is it at all essential to check the vital signs on every patient (or any patient for that matter) with the new 2021 E&M guidelines for documentation/billing purposes?

It is part of the physical exam so I think that it is not important at all for billing purposes. Is that correct?

Question 4 - minute 21:55

Please clarify using 99441-99443 codes. We have a provider that wants to bill for these to call patients with test results which one of them has resulted in scheduling a surgical procedure. These calls are not scheduled as a telehealth visit would be. Please advise.
Thank you for all your help.

Question 5 -

When billing a private/commercial payer, can we bill codes 51702 and A4344 together?
Thanks

Take the 30 Day Urology Coding Challenge and learn what a QHP should know and nothing more.

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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

31 min
February 15, 2021 UCR 038: What is the Urology QHPs Role in Coding and Billing

February 16, 2021

Ray and Scott discuss what a urology QHP should do and what they should not do. As we teach at PRS, you should always work at the top of your license. This does include some coding and billing. Ray and Scott discuss and give some examples of the role the QHPs.

Take the 30 Day Urology Coding Challenge and learn what a QHP should know and nothing more.

Learn More

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
28 min
February 05, 2021 UCR 037: E&M 2021 Risk - is prostate cancer with watchful waiting a level 2,3,4 or 5?
February 5, 2021

Mark, Ray, and Scott discuss Risk under the new E&M 2021 guidelines. Mark lays out a position that you can have a level 2, 3, 4, and 5 for watchful waiting for patients with prostate cancer. Your documentation is the key.

You need to provide the complete picture to include clinical and medical reimbursement perspectives.

Take the 30 Day "Code like Mark Painter" Challenge and finally master urology coding.

Learn More

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

30 min

About Urology Coding and Reimbursement Podcast

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The Urology Coding and Reimbursement Podcast is for Urologists and urology practice staff: Administrators, APPs, Billers and Coders. We help urologists and staff achieve peak economic and practice…