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Urology Coding Alert

Procedure Focus:
Keep These Tips in Mind When Reporting Robotic Pelvis Exploration
Category III code 0184T might not be your best option. Robotic procedures have become mor... Read more
CPT® 2020:
Watch the Associated Times for These New E/M Codes
New codes get more specific for digital service times. The closer the calendar rolls to 2... Read more
Clarify What Does – or Doesn’t – Constitute PHI
Tip: Keep this list of 18 identifiers to remember. These days compliance is tied closely ... Read more
Reader Question:
Check Payer Guideline for Inpatient Ureteral Catheter Coding
Question: A colorectal surgeon requested that our urologist insert a ureteral catheter dur... Read more
Reader Question:
Append Modifier 59 to 52204 When Submitting with 52351
Question: The coding edit between 52351 and 52204 lists 52351 as the comprehensive code, b... Read more
Reader Question:
Catheter as a Stand-alone Supply Is Not Separately Billable
Question: Can we bill for catheters if the patient couldn't be catheterized? The patient w... Read more
Reader Question:
Remember Imaging Guidance with Gold Seed Placement
Question: How do we report for a gold seed marker placement for future cyberknife radiatio... Read more
Reader Question:
Think ‘Also’ When Codes Include a Plus Symbol
Question: What does the plus symbol in front of some evaluation and management (E/M) servi... Read more
Reader Question:
No Need for Separate Sessions With 55700 + 52601
Question: The urologist performed a transrectal finger-guided biopsy of the prostate becau... Read more
You Be the Coder:
Watch the Details Associated with Submitting 52332 and 52204
Question: The urologist marked codes 52332 and 52204 on the paperwork for a procedure; bot... Read more
Procedure Focus:
Follow These Tips to Flawless Percutaneous Nephrostolithotomy Coding
Be careful when other services are included in the procedure time. When kidney or uretera... Read more
Test Your Real-World PCNL Knowledge
See how well you would fare in a true situation. Now that you've read about how to report... Read more
Don’t Miss These Possible Changes to Incident-to Parameters
Follow the correct rules to ensure payment for NPP services. “Incident-to” is a billi... Read more
Code Updates:
Watch for These New Code Options in 2020
Plus: Don't miss the update to urology code 54640. CPT® code additions, deletions, and r... Read more
Reader Question:
Steer Clear of Reporting Fluoroscopic Guidance with Lithotripsy
Question: When my urologist performs an ESWL, is ultrasound guidance and/or fluoroscopy in... Read more
Reader Question:
Yes, You Can Bill 52351 and 52204 Together
Question: I'm attempting to code based on the following documen­tation: “Dome of the bl... Read more
Reader Question:
‘Same’ or ‘Separate’ Guides Coding of 52356 and 52352 During Same Session
Question: I'm wondering what guidelines apply if the urologist completes procedures 52356 ... Read more
Reader Question:
Prostate Vaporization Code Hinges on Surgeon’s Tactic
Question: What is the correct way to report bipolar electrical vaporization of the prostat... Read more
Reader Question:
Code 74420 Represents Radiological Interpretation
Question: Documentation shows that our urologist performed cystoscopy, bilateral retrograd... Read more
You Be the Coder:
Correctly Report Cleaning of Suspected Wound Infection
Question: My urologist saw a patient with a suspected infection of an interstim device. Th... Read more
Procedure Focus:
Follow 4 Steps to Reliable Rectocele Repair Coding
Hint: Pay attention to other services performed during the same session. Treating a recto... Read more
Don’t Muddy the Lines of Code Selection Just to Get Paid
‘Coding for dollars' could have you paying a bigger price later. It's a scenario every ... Read more
Bolster Your Chances Against Hacks with Stronger Usernames and Passwords
Follow this advice to meet the fed's requirements. Your practice, like most others, proba... Read more
Reader Question:
Let Operative Report Guide Your Code Decision for Polyp Excision
Question: I need help coding an “excision of ureteral polyp.” I found one code for the... Read more
Reader Question:
Report Gold Seed Marker Placements with A4648
Question: The urologist completed a transrectal ultrasound, ultrasound for guidance, and p... Read more
Reader Question:
Pouchoscopy with Ureter Biopsy Falls Under 52204
Question: The operative report shows that the surgeon completed pouchoscopy with biopsy of... Read more
Reader Question:
Turn to 51700 for Bladder Instillation
Question: The urologist used a silver nitrate instillation into the patient's bladder beca... Read more
Reader Question:
Choose J9280 for Mitomycin Administration
Question: I have a physician who would like to give a patient Mitomycin. We normally use B... Read more
Reader Question:
Select a Single Code for Nephrectomy and Transplant
Question: The urologist performed a bilateral nephrectomy because both of the patient's ki... Read more
Reader Question:
Buccal Graft Has 2 Potential Code Choices
Question: My urologist performed a urethroplasty along with a buccal graft. How should I r... Read more
You Be the Coder:
Here’s the Better Choice for Prostatic Urethral Calcification
Question: The patient's prostate urethra was calcified due to previous radiation therapy. ... Read more
Procedure Focus:
Clarify the Ins and Outs of What Constitutes Duplex Scans
It all comes down to the equipment your provider used. Out of all the ultrasound procedur... Read more
Pinpoint the Diagnosis Difference Between Tenderness and Rebound Tenderness
Hint: The patient's description will help you make the choice. Some problems that patient... Read more
Office Visits:
Shore Up Your 99211 Coding with These 3 FAQs
Tip: Always know who provided the service. Of all the outpatient evaluation and managemen... Read more
Reader Question:
Report 52630 for Repeat TURP
Question: A urologist who is not in our practice performed a TURP on a patient in 201... Read more
Reader Question:
Penile Implant Replacement Falls Under 54410 Even for a Different Type
Question: A patient had three previous two-piece inflatable penile implants; each one... Read more
Reader Question:
52310 or 52315 May Not Be Correct for Migrated Stent Removal
Question: My doctor removed a ureteral stent that had migrated using a ureteroscopy (... Read more
Reader Question:
Code Retrograde Urography With 74420 and 52005
Question: How should I code an encounter that included cystoscopy, bilateral retrogra... Read more
Reader Question:
Get ABN Signed Before Nitrous Oxide Administration
Question: Our urology practice wants to start using nitrous oxide for in-office proce... Read more
Reader Question:
Examine Descriptor to Better Choose Between 49320 and 49322
Question: A patient underwent a left hand-assisted radical nephrectomy and then had t... Read more
You Be the Coder:
New Patient Visit About Vasectomy Can Be Moderate MDM
Question: What E/M level should we bill for new vasectomy patients in clinic? A couple of ... Read more
Don’t Miss 2 Important July 1 Urology Coding Changes
Verify that you're following the latest guidelines. Summertime always brings fresh rounds... Read more
Procedure Focus:
4 Simple Steps Help Pinpoint the Correct PSA Choices
Tip: Look to ‘G' code for Medicare patient screening. Prostate specific antigen (PSA) t... Read more
Diagnosis Update:
Don’t Miss These Urology Additions Within the Upcoming ICD-10 Changes
Watch your spelling with one tiny descriptor shift. CMS has released the first look at up... Read more
Reader Question:
Check Procedure Notes Before Assuming 50940 Is Correct
Question: One of our doctors completed a procedure that may qualify for code 50940. He was... Read more
Reader Question:
Opt for Diagnostic Code for Bladder Laparoscopy
Question: Is there a specific CPT® code for a diagnostic laparoscopy? The urologist noted... Read more
Reader Question:
Get Clear Documentation of Cystoscopy With Other Procedures
Question: Our urologist performed a cystoscopic examination with incision of a left ureter... Read more
Reader Question:
Include Modifier 59 to Capture TURP, Prostate Needle Biopsy, and TRUS
Question: The urologist performed a TRUS and prostatic needle biopsy because of an elevate... Read more
You Be the Coder:
Cystoscopy With Attempted Stent and Fluff Removal
Question: The urologist performed cystoscopy to diagnose bladder cancer and right hydronep... Read more
Procedure Focus:
Biopsy or Aspiration? Here’s How to Know the Difference
Hint: Needle size can help you distinguish. The world of medicine includes numerous pinpo... Read more
Modifier Focus:
Follow These Urology Scenarios to Find Success with Modifier 58
Planning the procedure makes all the difference in your claim. You might not report modif... Read more
Modifier Mix-Up:
Don’t Confuse Modifier 58 With 78
Check for planned vs. unplanned for guidance. When considering whether to report modifier... Read more
Reader Question:
Don’t Jump to Unbundle 76000 From 50590
Question: Are we allowed to bill 50590 with 76000? Delaware Subscriber Answer: According... Read more
Reader Question:
Watch Dates and Codes for PCNL Followed by Nephrostomy Catheter
Question:  A patient had a PCNL on 04/03/2019. On 05/03/2019 the patient returned for... Read more
Reader Question:
Complications During Colectomy Can Lead to Multiple Codes
Question: A patient was scheduled for an open sigmoid colectomy by the GI surgeon. A bladd... Read more
Reader Question:
Double PSA Test Does Not Merit Modifier 91
Question: We occasionally have patients whose PSA numbers are so high that they are above ... Read more
Reader Question:
Yes, You Can Report Barbotage With Cystoscopy
Question: Would a barbotage urine sample done at the same time as cystoscopy ever be coded... Read more
Reader Question:
Turn to Separate Codes for Tests Without a Panel
Question: The urologist ordered a 24-hour urine collection to assess calcium, oxalate, cit... Read more
Reader Question:
Use of Clamp May Not Point to 54150 Over 54161 for Phimosis
Question: The urologist performed a circumcision on an 80-year-old male. The diagnosis was... Read more
You Be the Coder:
Watch Whether 76872 Overrides 76942
Question: I've recently returned to urology coding after spending several years in another... Read more
Procedure Focus:
Coding for Penile Prosthesis Centers on Components
Don't miss your chance for extra reimbursement if complications arise. When the urologist... Read more
E/M Coding:
Take Time to Refresh Your Time-based Coding Tactics
Follow these 4 tips for better success. Every coder has worked with providers who believe... Read more
Steer Clear of Gray Areas That Could Lead to MIPS Mishaps
Don't fall victim to these potentially risky actions. Merit-Based Incentive Payment Syste... Read more
Reader Question:
Steer Clear of Reporting 51700 With 52649
Question: Can we bill for 51700 if it was completed during the global period following 526... Read more
Reader Question:
Complicated Catheter Insertion Could Lead to 51703
Question: I'm confused about whether to report a procedure as a complicated catheter chang... Read more
Reader Question:
Submit 50949 for Robotic-assisted Laparoscopic Stricture Repair
Question: The urologist completed a robotic-assisted laparoscopic ureteroileal re-implanta... Read more
Reader Question:
Get Clear Documentation Before Assigning Cancer Diagnosis
Question: One of our physicians saw a Medicare patient and on examination suspects that he... Read more
You Be the Coder:
Coding for Cystoscopy with Stent Removal
Question: The urologist began a percutaneous nephrostomy to look for a stone. He did not f... Read more
Procedure Focus:
Remember These Guidelines When Coding Cystoscopy With Bladder Tumor Resection
Size matters more than quantity. Performing a cystourethroscopy is standard fare for urol... Read more
E/M Coding:
Are You Up to Date on the New Codes for Using Technology?
Here are your steps to internet, telephone, and remote coding options. As the technology ... Read more
Get Your Latest CMS News Via Podcast
Feds continue to go mainstream with information sharing. If you're a podcast fan, you now... Read more
Reader Question:
Don’t Assign Reimbursement Value to a Xyosted Sample Injection
Question: The urologist administered an injection of a Xyosted sample. We're billing an E/... Read more
Reader Question:
Be Sure to Meet the Criteria Before Reporting Consult
Question: The gastroenterologist performed a takedown of a patient's colostomy. She attemp... Read more
Reader Question:
Check Whether 49060 Might Suffice for Decortication of a Retroperitoneal Abscess
Question: What procedure code do we use for decortication of a retroperitoneal abscess? W... Read more
Reader Question:
Get Clear Documentation Before Reporting Multiple Services
Question: The urologist completed cystoscopy with left retrograde pyelogram, left ureteral... Read more
Reader Question:
Code TUNA With 53852
Question: Our urologist performed a transrectal ultrasound on a patient prior to a transur... Read more
Reader Question:
Procedure Codes Normally Include Fees for Necessary Supplies
Question: Can we bill for supplies used during surgical procedures in our office, such as ... Read more
You Be the Coder:
Check These 3 Options for Renal Tumor Ablation
Question: What is the correct way to bill for ablation of renal tumors? Can I bill fo... Read more
Procedure Focus:
Sites and Agents Are Your Top Details for Urethral injection Success
Heads up: Remember you won't always be paid for the injection agent. Urologists might per... Read more
Coding Basics:
Unlisted Procedures Don’t Have to Mean Unattainable Payment
Focus on 5 details to find your way to success. Unlisted procedures might seem like the b... Read more
News to Know:
CMS Introduces New Podcast for Updates
Add CMS to your playlist to get the latest on policy changes. If you're into podcasts for... Read more
Reader Question:
Report 20501 for a Fistulogram in an Ambulatory Surgery Center
Question: Our provider performed a cystoscopy, bladder biopsy with fulguration, and fistul... Read more
Reader Question:
Verify Criteria Before Reporting Modifier 24
Question: A patient came to our office for a follow-up visit during his surgery's global p... Read more
Reader Question:
Remember That 52356 Includes the Work of 52351
Question: The surgeon completed cystoscopy and right ureteroscopy with laser lithotripsy a... Read more
Reader Question:
Watch the Time When Hoping to Report a Level 5 E/M Service
Question: Is it true that most new patient visits when the urologist counsels the patient ... Read more
Reader Question:
Check for Coding Edits for Multiple Procedures in a Session
Question: I'm coding for many procedures during the same operative session: cystoscopy wit... Read more
Reader Question:
Prepare for LCDs to Begin Eliminating Specific Codes
Question: I heard there are some changes in the works related to LCDs and the codes associ... Read more
Reader Question:
Documentation Can Help You Code by Time
Question: We have a provider who sees a lot of pediatric patients with their parents. The ... Read more
You Be the Coder:
The Usual Diagnosis for Ureteral Stent Removal
Question: A patient came to our facility for removal of a left ureteral stent. I'm debatin... Read more
Rare Code Refresher:
Do You Know How to Handle Coding for Urethral Diverticulum Excision
Reaching a solid diagnosis might be the trickiest part of the process. Urethral diverticu... Read more
Code Update:
Don’t Miss These Final 5 HCPCS Code Changes
Pay special attention to the revision of G9633. Just because code changes for each upcomi... Read more
Reader Question:
Code for Removal of Duplicate Urethra Depends on Circumstances
Question: Which code should I report for excision of a duplicate urethra? The urologist is... Read more
Reader Question:
Compare Renal Hilar Skeletonization to 64722
Question: The urologist performed what she documented as “laparoscopic right renal hilar... Read more
Reader Question:
Follow-up Wound Closure After Nephrectomy Is 13160
 Question: A patient recently had an open radical nephrectomy. The wound opened and t... Read more
Reader Question:
Yes, You Can Code Each Stone When In Separate Structures
Question: A patient was taken to the OR for right ureteroscopy and laser lithotripsy. The ... Read more
Reader Question:
Submit 56441 for Lysis of Clitoral Adhesions
Question: A patient was diagnosed with vulvodynia. The urologist performed a lysis of clit... Read more
Reader Question:
Mesh Is Considered Part of Code 57282 Work
Question: When the urologist performs 57282 and uses mesh, is the mesh included in the mai... Read more
Reader Question:
Expect to Be Paid for the New Telemedicine Codes
Question: I haven't had to report any of the new telemedicine codes for 2019 yet. What sho... Read more
Reader Question:
Remember This About ‘Extended’ HPI Reporting
Question: One of our physician assistants believes that if she has an extended HPI, she ca... Read more
Reader Question:
Feel Free to Submit QPP Data Anytime
Question: When are we allowed to submit quality data from our providers for 2018? Oklahom... Read more
You Be the Coder:
Diagnosis for Incomplete Bladder Emptying
Question: What is the best diagnosis code to report for incomplete bladder emptying? I'm l... Read more
The First Coding Edits of 2019 Bring Thousands of Changes: Are You Ready?
Pay close attention to when urology codes are Column 1 vs. Column 2. The new edition of C... Read more
Descriptor Check:
Understand the Services That 99451 and 99452 Represent
Hint: It centers on which side of the consultation you're reporting. With so many CCI edi... Read more
2019 Will Bring a Bit Higher Pay, Thanks to Conversion Factor Update
Remember that local geographic factors can change your bottom line. As 2019 gets underway... Read more
Reader Question:
Yes, You Can Report 52281 Even Without Using Dilators
Question: The urologist guided a 17 French cystoscope into the patient's bladder. There wa... Read more
Reader Question:
Open Approach to Renal Cyst Excision Means 50280
Question: The surgeon excised a large renal cyst (16 cm) at the level of normal kidney par... Read more
Reader Question:
Base Resection Code on Lesion Size
Question: A patient has a history of bladder cancer and had a previous resection of a blad... Read more
Reader Question:
Colpopexy in Code 57282 Includes Culdoplasty
Question: The urologist performed sacrospinous ligament fixation and Halban culdoplasty du... Read more
Reader Question:
‘Unplanned’ and ‘Repeat’ Help Distinguish Modifiers 77 and 78
Question: A urologist from another practice performed a TURP on a patient (52601). Three d... Read more
Reader Question:
Stop Yourself Before Reporting Urolift Implant Removal
Question: A patient had implants placed in 2016. Our urologist just performed a TURP on th... Read more
You Be the Coder:
Coding for 52000 With 51701
Question: I know that CCI edits bundles code 52000 with 51701 and that no modifier is allo... Read more
Coding 101:
Get Answers to Your Common Questions about Voiding and Irrigation
Turning to 51700 isn't always the correct tactic. Coding for bladder voiding or irrigatio... Read more
Faced With Concurrent Care? Follow These Tips for Smooth Submissions
Hint: Much of your success hinges on documentation. Concurrent care of a patient can lead... Read more
Reader Question:
Choose Between 54410 and 54411 for Inflatable Penile Prosthesis, IPP, Reservoir Removal
Question: Does CPT® include a code for removal of only an IPP reservoir? Or is my best op... Read more
Reader Question:
Think of 'Foreign Body' as Originating Elsewhere
Question: What is a good definition for foreign body in relation to coding? Is it consider... Read more
Reader Question:
'Unobtainable' Can Be Factored into the History Decision
Question: A patient injected himself with a silicon agent into the scrotum. We were not ab... Read more
Reader Question:
Steer Clear of Reporting 52000 With 51701 
Question: Are we allowed to report 52000 and 51701 on the same claim? Louisiana Subscribe... Read more
Reader Question:
Add 74420 to Claim if Insurer will Allow with a Cystoscopy and Retrograde pyelogram
Question: I am coding for left ureteral stent removal, retrograde pyelogram, and ureterosc... Read more
Reader Question:
Learn Your G Modifiers for ABN Success
Question: I'm working on a claim for a Medicare patient that includes an advance beneficia... Read more
Reader Question:
Follow Location to Correct TCM Code
Question: I'm still trying to get a grip on the transitional care management codes. W... Read more
Reader Question:
HIPAA Regulations Still Apply to BBAs, Even Across Borders
Question: Our practice uses a small cloud services provider (CSP) based in Canada to store... Read more
Reader Question:
'Negative' ROS Systems Don't Lead to 'Complete'
Question: Can we count a “complete” ROS when the surgeon includes a statement such as ... Read more
You Be the Coder:
Reporting an Uncomplicated Foley Switch
Question: Would 51702 be appropriate to use for an uncomplicated exchange of a Foley cathe... Read more