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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
Compliance:
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
Checkpoint:
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
Billing:
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
Reimbursement:
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
Security:
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
ICD-10-CM:
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
CCI:
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
Compliance:
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
Compliance:
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
Compliance:
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
Reimbursement:
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
Compliance:
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