February 2, 2024

Ray, Mark, and Scott answer and discuss the following questions:

1. The seminar this past week was great. I have one question that I asked during the seminar but still not sure of the correct answer. For an initial hospital consultation, I have been using 99223 and generally 99232 for follow up visits. Is this correct.
2. Seeking clarification for the best way to code:
3. Ureteroneocystostomy; anastomosis of single ureter to bladder with vesico-psoas hitch
4. --Robotic approach
5. is it an unlisted code or 50948? Thank you in advance :)
6. I've received several questions recently on whether or not certain procedures can be performed in office by an APP alone (51720, 95972, Eligard/Firmagon injections etc.). Most codes as long as they are not surgical can be performed by an APP since they are a qualified healthcare provider, correct? Not sure where I can find info on this. I did check state statutes but found nothing specific about which procedures. Thanks!
7. If a patient comes in for routine SPT change or lupron injection, and provider states return in a week or month for next change or injection, is that enough for a modifier -25 to billed?
8. For the 99459 we have a gynurologist she does pelvic exams on almost all her patients unsupervised can we still add this code to her visits? Thank you

G2211 Guidance Document [free download]

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The Thriving Urology Practice Facebook group.

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January 19, 2024

Scott and Mark discuss the topics of G2211 and code 99459. They clarify some common questions and confusion surrounding these codes, provide guidance on their appropriate use, and share updates on their experience with Medicare, Medicare Advantage plans, and private payers. They also talk about code 99459 and the importance of documenting the presence or absence of a chaperone during a female pelvic exam.

G2211 Guidance Document [free download]

Click Here for the Link to Download the Guidance Document 

___

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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January 12, 2024

Scott and Dr. Ray Painter discuss the top issues impacting urologists and their practices.

G2211 Guidance Document [free download]

Click Here for the Link to Download the Guidance Document 

Urology Advanced Coding and Reimbursement Seminar

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New Orleans, January 26 & 27, 2024
8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday

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 Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.

The Thriving Urology Practice Facebook group.

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January 5, 2024

Mark, Scott, and Dr. Ray Painter discuss the new G2211 code.  How it should be used, examples, provide scenarios, and share questions about using the code.

G2211 Guidance Document

Click Here to get free Download Link  (available January 8th, 2024)

Urology Advanced Coding and Reimbursement Seminar

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New Orleans, January 26 & 27, 2024
8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday

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© 2024 Physician Reimbursement Systems, Inc.

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December 29, 2023

Mark, Scott, and Dr. Lin discuss topics from the Thriving Urology Practice Facebook Group:

1. There is still no CPT code for extricating the penis from a foreign body, right?
   Guy used a 2.5 pound weight plate as a penis ring. Took an ortho saw to remove it.
   Medtronic Midas Rex handheld device with a circular Diamond bit saw was used to cut the plate at 3 and
   9 o’clock positions. 2 separate Medtronic Midas Rex devices had to be used due to heat generation.
   Complete transection of the plate was performed. Penis was protected from the heat and the blade to
   effect a successful extrication.
2. How do we bridge the gap between those urologists and APPs who are practicing
   happily and getting paid for everything they do, not spinning their wheels, not burning
   out, vs. those who continue to suffer?

Urology Advanced Coding and Reimbursement Seminar

(Click Here for More Information and Registration) 

New Orleans, January 26 & 27, 2024
8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday

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 Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

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Join the discussion:

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

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December 22, 2023

Mark, Ray, and Scott answer questions from the PRS Urology Coding Community:

1. I have multiple providers who want to bill 55867 & 51860 for the same procedure. While there’s isn’t an NCCI Edit for these codes, you can see that the procedure description includes both the making of an incision in the bladder wall and then later the suture repair. Coding guidelines dictate that since you could not perform the main surgical procedure without the minor one, then the minor is bundled into the major. As a coder I don't feel that there is support for separate reimbursement when the two codes are routinely billed together. Their contention is that there are 2 ways to do a simple prostatectomy. The first is through the capsule of the prostate gland without a bladder incision. The simple prostatectomy code has traditionally encompassed the first way of not making a bladder incision and if an incision was made then a cystorrhaphy was billed. With the addition of the new code specifically for the simple prostatectomy, I would like some direction on how these codes should be billed.
2. Have you been able to lookup what the reimbursement will be for the new CPT code 99459 for female pelvic exam?
3. Can 51741 and/or 51798 be billed twice on the same day?
   For example, if a patient does the first urofow and the volume is not adequate and then we have him drink and come back later for a second uroflow. 
4. When billing 51700 for voiding trial post-op after prostatectomy (90 day global), is a modifier needed ? Such as modifier 58

Urology Advanced Coding and Reimbursement Seminar

(Click Here for More information and Registration) 

New Orleans, January 26 & 27, 2024
8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday

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 Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.

The Thriving Urology Practice Facebook group.

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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

 December 15, 2023

Mark, Ray, and Scott welcome Dr. Richard Pelman to discuss the importance of State Urology Societies and why you should participate.

Urology Advanced Coding and Reimbursement Seminar

(Click Here for More information and Registration) 

New Orleans, January 26 & 27, 2024
8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday

Reserve your spot and save!

 Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.

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

December 8, 2023

Mark, Ray, and Scott welcome Dr. John Lin to discuss the 2024 Urology Coding and Reimbursement Seminar and share their thoughts about the 2024 Urology Coding and Reimbursement Seminar in Las Vegas, on December 1st and 2nd, 2023.

Urology Advanced Coding and Reimbursement Seminar

(Click Here for More Information and Registration) 

New Orleans, January 26 & 27, 2024
8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday

Reserve your spot and save!

 Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.

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

December 1, 2023

Mark, Ray, and Scott welcome Dr. Jonathan Rubenstein to discuss the big CMS changes for urology in 2024 and how to implement them.

 
Urology Advanced Coding and Reimbursement Seminar

(Click Here for More information and Registration) 

New Orleans, January 26 & 27, 2024
8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday

Reserve your spot and save!

 Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.

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

November 22, 2023

Mark, Ray, and Scott discuss Part B drugs and how a practice can compare clinically similar drugs.

Telehealth Resource Centers

https://telehealthresourcecenter.org/

Urology Advanced Coding and Reimbursement Seminar

(Click Here for More information and Registration) 

Las Vegas, December 1 & 2, 2023
8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday

New Orleans, January 26 & 27, 2024
8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday

Reserve your spot and save!

 Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.

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

 Mark Painter and PRS Consulting

Schedule a call with Mark Painter or Larry Kemp / PRS Consulting