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Urology Coding Alert

CCI 15.3 Update:
Don't Expect Extra Pay for Moderate Sedation, Thanks to CCI 15.3
You'll now find 76000-76001 bundled with many urological procedures. The last quar... Read more
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Navigate Your Way to Proper Modifier 59 Use With This Chart
Watch out: If you override every ‘1' bundle, you're asking for trouble. ... Read more
Let 3 Clinical Scenarios Guide Your Nephrectomy Code Choice
Watch for additional procedures, such as biopsies, that you can also code. No two surgeri... Read more
Reader Questions:
Support Cyst Excision With Proper Dx Codes
Question: My doctor did an excision of a perineal sebaceous cyst. How should I code this?... Read more
Reader Questions:
Include Suture in 52601
Question: My urologist performed a TURP followed with a suprapubic cystotomy with suture ... Read more
Reader Questions:
Capture All Components of Robotic Procedures
Question: How should we code a robotic hysterosacrocolpopexy? Should I use the open uteri... Read more
Reader Questions:
Capture Payment When Doc Gets Called to OR
Question: Another physician called my doctor into the operating room. During a gynecologi... Read more
Reader Questions:
Use 50 for Bilateral Orchiopexy
Question: How do I report a bilateral orchiopexy with detachment of the right cremasteric... Read more
Reader Questions:
Use 50 for Bilateral Orchiopexy
Question: How do I report a bilateral orchiopexy with detachment of the right cremasteri... Read more
Reader Questions:
Your E/M Doesn't Have to Match the Hospital's E/M
Question: My urologist simply removes a foley catheter in an outpatient hospital exam roo... Read more
You Be the Coder:
Which Pieces of a Fistulogram Can You Code?
Question: How do I code a fistulogram? The operative note states that the urologist perfo... Read more
Be Persistent With 55899 for Cyberknife Prostate Procedures
Tip: Some payers may still want you to report a deleted CPT Code . Too much money paid... Read more
Always Using a Consult Code in the OR Can Get You in Hot Water
Hint: If you can't prove the request for an opinion, don't use 99251-99255. Wh... Read more
Watch Out for 3 Telephone Service Coding Pitfalls
Caution:You may need to incorporate the call into an in-office E/M service. If you're rep... Read more
Reader Questions:
Paint the Clot Retention Picture With 598.6
Question: Our doctor performed a cystoscopy with clot evacuation, tumor fulguration, and ... Read more
Reader Questions:
Stoma Repair Leads to 49560-49566 or 50728
Question: A patient has an ileal conduit. He developed a ureterointestinal stricture, so ... Read more
Reader Questions:
Payer Preference Determines G0027 Vs. 89321
Question: Code HCPCS G0027 is listed as a providerperformed microscopic procedure to te... Read more
Reader Questions:
Number of Nodes Doesn't Point to Full or Limited
Question: What is the difference between a limited pelvic lymphadenectomy and a total bil... Read more
Reader Questions:
Don't Forget US Guidance With Brachytherapy
Question: What codes should we use for prostate brachytherapy or seed implantation for pr... Read more
You Be the Coder:
Capture Urologist's Portion if IR Performs Access
Question: I am wondering how best to code percutaneous nephrolithotripsy when interventio... Read more
Shore Up Your Prolapse Procedure Coding in Just 3 Steps
Key: Approach is the first documentation detail you should look for. Many urologists perf... Read more
News You Can Use:
No-Pay Proposal for Consults Could Make Coding Easier
Plus, you may have one more modifier to add to your arsenal. If you cringe every time you... Read more
Don't Miss Out on $260 in Additional Pay
Code for mesh insertion with some prolapse procedures. During some prolapse repair proced... Read more
Discover How Fee Changes Affect Your Practice Next Year
Your urologist will likely feel the pain more than his IM colleagues. As you read in the ... Read more
Reader Questions:
Capture Fulguration Pay With Modifiers
Question: If my physician went to do a TUIBNC and found bleeding of prostatic varices, fu... Read more
Reader Questions:
Urethrotomy and Biopsy Offer 3 Code Solutions
Question: The physician did a direct vision internal urethrotomy and then did a biopsy of... Read more
Reader Questions:
Choose 53 for Discontinued Procedures
Question: My urologist started a lap prostatectomy. Mobilizing the bladder revealed a hig... Read more
Reader Questions:
Code Both Separate E/M and Debridement
Question: Can you charge for an inpatient consult and a bedside debridement on the same ... Read more
You Be the Coder:
Nephrectomy With Adrenal, Lymph Removal
Question: A patient had an adrenal tumor and a renal tumor, as well as peritoneal lymphad... Read more
Stop Missing Out on Extra After-Hours Payment
Staying open late isn’t just a patient convenience it can bring in cash, too.... Read more
ICD-9 2010 Update:
Get Ready Now for Urinary Diversion, Renal Disease Dx Changes in October
Plus, you’ll have additional personal history V codes for next year. In just a f... Read more
Don'tWait 3Years to Start Thinking About ICD-10
Take advantage of the time you have to prepare for the coming changes. Now is not too ... Read more
Reader Questions:
Separate Stone ProceduresWarrant 2 Codes
Question: My physician performed a cysto with left stone manipulation, and after that an ... Read more
Reader Questions:
Use Cancer Dx for Chemo Treatments
Question: What diagnosis would I use for "muscleinvasive bladder cancer post-radical cyst... Read more
Reader Questions:
50688 Is for Unilateral or Bilateral
Question: How should I report a cystoscopy and change and replacement of right ureteral s... Read more
Reader Questions:
Technique Doesn't Alter Stricture Coding
Question: I work for a board-certified urologist and surgeon who performed a “lase... Read more
You Be the Coder:
Bridge Technique Prostatectomy
Question: My urologist performed a Holmium laser prostatectomy via a “BRIDGE&rdquo... Read more
Avoid Losing Up to $125 in Vasectomy-Related Payment With This 4-Step Coding Process
Turn to V25.x for your diagnosis code choice. Vasectomies are commonplace in most urology... Read more
Confirm Vasectomy Procedure Coverage Before Coding
Tip: Collecting a deposit can cut down on your no-shows. Some payers won't reimburse you ... Read more
3 Expert Answers Can Relieve Your Consultation Coding Fears
Caution: Avoid adding a consultation to every surgical procedure. Consultation coding is ... Read more
Reader Questions :
Consider 12001 Inherent to Implant Procedure
Question: One of my providers and I are having a debate. Can he bill CPT 11981 -11983 and... Read more
Reader Questions :
Pull Out Hernia Repair for Coding Purposes
Question: Can we bill for an inguinal hernia repair (CPT 49525 ) when the physician perfo... Read more
Reader Questions :
Botox Coding Differs for Cigna
Question: How should I report Botox bladder injections for a Medicare patient? North Caro... Read more
Reader Questions :
Submit 2 US Codes for TRUS + Seed Placement
Question: How should I report the placement of gold seed markers and a TRUS done in the o... Read more
You Be the Coder :
Release of Hidden/Buried Penis
Question: My urologist performed a procedure on a patient for "release of hidden penis." ... Read more
Pick Between Laser Prostate Treatment Codes With Ease
Hint: Focus on the results, not the type of laser. When your urologist documents that ... Read more
Appending Modifiers 54 and 55 Takes Great 'Coordination'
Tip: If the other physician involved is not coding correctly, youre out of luc... Read more
Put Patient -- Not Money -- First With Split Surgical Care
Plus, pay attention to whether your payer is recognizing your modifiers. ... Read more
Reader Questions:
Remember 78 for Sling Revisions
Question: A patient had a sling procedure (CPT 57288 ). She then needed a revisi... Read more
Reader Questions:
Bill for Reduction of Adherent Foreskin
Question: My urologist is asking me if he can get compensated in addition to t... Read more
Reader Questions:
Settle the P9612 vs. 51701 Debate
Question: I need help to clarify when to use HCPCS P9612 versus CPT 51701 for... Read more
Reader Questions:
Use 2 Codes for Multiple Fulgurations
Question: One of our patients had a vesicovaginal fistula. The op report reads... Read more
Reader Questions:
Clue Payers in to Lesser Procedure With Modifier 52
Question: One of the urologists in our practice performed a removal of AUS cuf... Read more
Reader Questions:
Avoid 62 for Different Procedures
Question: I have a situation where my doctor and another doctor (not associate... Read more
Reader Questions:
Tap Into E-Scribe 2 Percent Bonus Basics
Question: I heard that physicians may receive bonuses for e-prescribing. What ... Read more
You Be the Coder:
Does Male Sounding Equal Calibration?
Question: The patient has prostatitis and massive BPH. The urologist performed... Read more
Screen PSA Documentation to See When Claims Deserve a G Code
Plus, make sure you know when to support your coding with V76.44. P... Read more
Solidify PSA Documentation With a Code-Focused Order
Have the urologist select screening or diagnostic from the get-go. ... Read more
CCI 15.1 Update:
Weed Your Way Through More Than 300,000 New CCI Edits
The good news: None of the edits will be a big drain on your reimbursement. If the new... Read more
Reader Questions:
Unbundling Isn't Quite the Same for an Assistant
Question: One of my doctors performed a sling (CPT 57288 ) and cystocele repair.... Read more
Reader Questions:
View Unlisted Code as Code of Last Resort
Question: The urologist documented that he performed an endoscopic injection o... Read more
Reader Questions:
Include Ab Exploration in Surgical Code
Question: Several days after a total cystectomy and continent urinary diversio... Read more
You Be the Coder:
Multiple Procedures, 2 Physicians, Same Practice
Question: We are a group of urologists that bill under a common group NPI. One o... Read more
Don't Let Catheter Coding Mistakes Drain Your Reimbursement
Tip: Check to see if an E/M code is appropriate for catheter removals. Catheterizations... Read more
Quick Quiz:
Test Your Knowledge of the Now-Required ABN Form
See if you need to hone your ABN skills with this quiz. The drop-dead date for using the ... Read more
Case Study:
Double ESWLs Do not Have to Mean Double the Headache
You may need to appeal to get proper payment. When your urologist performs the same proce... Read more
Quick Quiz Answers:
Quick Quiz Answers:
Find out if you're set to use the new ABN form by checking your answers to the five quiz ... Read more
Reader Questions:
Capture Entire Node Dissection in Your Coding
Question: What would be the correct CPT Code for a para-aortic lymph node dissection? My... Read more
Reader Questions:
Don't Append 51 to Add-on Codes
Question: How would I code for an abdominal wall plasty and umbilicoplasty? Should I use... Read more
Reader Questions:
Avoid 52612 Going Forward
Question: I have tried to find a code for a resection of a prostatic nodule. I don't thi... Read more
Reader Questions:
Open Code Doesn't Apply to Perc Procedure
Question: I'm trying to find the code for a percutaneous cystolithotomy. I can only find ... Read more
Reader Questions:
Support Unlisted Codes With Solid Documentation
Question: What code should I use for a penile sonogram -- not a Doppler study? Texas... Read more
Reader Questions:
Multiple Diagnoses all Count for Payment
Question: My urologist documented that he performed a release of skin bridges, times thre... Read more
Reader Questions:
Urosepsis Doesn't Equal Septicemia
Question: My urologist documented a patient's diagnosis as "urosepsis." The patient is s... Read more
You Be the Coder:
Robotic Surgery Diagnosis Coding
Question: What diagnosis code should I use when the urologist is using robotic equipment ... Read more
Case Study:
Mind Your Modifiers When Your Urologist Works With Another Doctor
Automatically appending modifier 52 could be costing you hundreds. When your urologist... Read more
52 vs. 53
Modifier 52 (Reduced services): Modifier 52 applies when "a service or procedure is... Read more
62 vs. 80
Modifier 62 (Two surgeons): You should look to modifier 62 when your urologist participa... Read more
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Capture Orchiopexy and Hernia Repair Pay With This Chart
Let the surgical approach guide your code choices. As explained in "Mind Your Modifiers W... Read more
Is This Biopsy Mistake Costing Your Practice Hundreds?
Tip: Look beyond the term 'fulguration' when you choose your codes. If you're billing e... Read more
Reader Questions:
CPT Doesn't Offer 53515 Specifics
Question: How should I code for a repair of a prostate laceration using sutures? The inju... Read more
Reader Questions:
Does Lack of Cysto Affect Code Choice?
Question: What is the proper code for a urethroscopy with fulguration of a small intraure... Read more
Reader Questions:
Prepare to Justify Unlisted Thrombectomy Coding
Question: My doctor did a hand-assisted laparoscopic radical nephrectomy with vena cava t... Read more
Reader Questions:
Include Prostate Massage With E/M
Question: My doctor is doing a test called PSA3. We are considering doing this in our fac... Read more
Reader Questions:
You Won't Need to Unbundle Therapy Codes
Question: We have a new doctor and new nurses who are performing pelvic floor therapy and... Read more
You Be the Coder:
Stop Losing $15 Per Iliac Node Biopsy
Question: The urologist says he biopsied the iliac node. I can't find a code for this pr... Read more
CCI 15.0 Update:
Ease the Burden of CCI 2009 Round 1 By Learning These 3 Themes
Checking the modifier indicator is your key to navigating the new edits. As of Jan. 1, ... Read more
Learn When You Can Override CCI Edits, Legitimately
Get reimbursement for bundled codes in 3 simple steps. There are times when you can ov... Read more
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Here's Your Handy Guide to the 15.0 CCI Edits
Save this useful list to help troubleshoot when you're dealing with these changes. If you... Read more
Recognize Incident-To Services or Pay the 15-Percent Price
Knowing the rules determines 100 percent vs. 85 percent reimbursement. In the office sett... Read more
READER QUESTIONS:
Replace 61793 With 55899 for Cyberknife
Question: I'm suddenly getting denials when my urologist performs a cyberknife procedure... Read more
READER QUESTIONS:
Consult CPT Errata and Update Your Manual
Question: My CPT Manual says that the definition for modifier 22 is "unusual procedural... Read more
READER QUESTIONS:
Bilateral Status Depends on the Payer
Question: When an urologist performs bilateral retrogrades is it allowable to bill CPT 5... Read more
READER QUESTIONS:
Anatomy Matters for Washing Codes
Question: My urologist performed a cystoscopy with bilateral kidney (renal pelvis) washin... Read more
READER QUESTIONS:
HCPCS Codes Are Your Best Bet for BCG
Question: How should I code for BCG treatments? Should I use CPT 90586 rather than J90... Read more
You Be the Coder:
Terminated Sling Procedure With Cysto Exam
Question: My urologist was scheduled to perform a sling procedure (CPT 57288 ). His oper... Read more
Capture Every Step of Voiding Trials to Ensure Top-Notch Reimbursement
Assuming you only need one code might be costing you double-digit amounts.Your urologist s... Read more
Reap the Rewards of Proper Level of Service E/M Coding
Figure out if your practice is losing money with this consultation scenario.Reporting the ... Read more
News You Can Use:
Medicare Lowers Conversion Factor to $36.0666 for 2009
But you won't feel as much of a crunch, thanks to a budget neutrality adjustment. ... Read more
Reader Questions:
Careful +69990 Coding Means $225+ Per Procedure
Question: How would I code a bilateral subinguinal microsurgical varicocelectomy when the ... Read more
Reader Questions:
Modifier 24 Is Your Answer to Admit During Global
Question: I have a patient who had more than one ESWL. The doctor admitted the patient for... Read more
Reader Questions:
Look for 'Penetrating' Wound With 20102
Question: A patient presents with a non-healing surgical wound from a past nephrectomy i... Read more
Reader Questions:
E/M Is Your Best Bet for Suture Removal
Question: I have a case where the patient went out of state for surgery (a 90-day global p... Read more
You Be the Coder:
Clot Evacuation and Fulguration at Bladder Neck
Question: Can you help me code this case? The operative report says the pre-op diagnosis i... Read more
CPT 2009:
Toss the 'Once in a Lifetime' TURP Rule Out the Window
Come January, your prostate coding will undergo major changes. "Code 52601 is a o... Read more
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Update Your TURP Coding With This Handy Chart
Prostate resection coding is still as easy as following the path. Choosing the proper ... Read more
CPT 2009:
Get Ready for Saturation Biopsy Coding Changes
Plus: Add several new Category II codes to your PQRI arsenal. You'll have more tha... Read more
CPT 2009:
Prepare to Get Specific With Prolonged Services Coding
You'll have one less modifier to contend with in 2009If you're used to adding modifier 21 ... Read more
Reader Questions:
Battle Botox Denials With Documentation
Question: My doctor is a urogynecologist. He will inject Botox into the bladder musculatur... Read more
Reader Questions:
Consider Koch Pouch a Bladder Substitute
Question: How should I code for a stone extraction from the Koch pouch?Alabama SubscriberA... Read more
Reader Questions:
Turn to 55450 for Swollen Penis Reduction
Question: I need help in coding a "reduction of paraphimosis" for a 78-year-ol... Read more
Reader Questions:
Don't Rule Out 93975 With Ultrasound
Question: We do scrotal ultrasounds (CPT 76870 ) in the office. We bill them with the TC m... Read more
Reader Questions:
Master Modifier 51 Once and For All
Question: I am uncertain about when I should use modifier 51. Do some carriers no longer a... Read more
You Be the Coder:
Lap Bladder Diverticulum
Question: The urologist performed a laparoscopic bladder diverticulum. What is the best wa... Read more
Quick Quiz:
Have a Handle on the Latest Dx Changes? Test Yourself
Take this quiz to see if you need to revisit the ICD-9 Updates Your practice should b... Read more
Quick Quiz Answers:
Have a Handle on the Latest Dx Changes? Test Yourself
Check the answers to see where you need to focus your education How did you fare on th... Read more