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Urology Coding Alert

Laparoscopy Coding:
50544: Let 3 Scenarios Guide Your UPJ Obstruction Coding
Don't miss out on additional procedures and services for which you deserve reimbursement.L... Read more
Medically Unlikely Edits:
Overcome MUE Denial Challenges By Busting 4 Common Myths
If you ignore the medically unlikely edits, you're asking for a denial.If you're receiving... Read more
OIG Watch:
Practices Collected Over $8 Million for Services Rendered After Patients Died
OIG identified massive overpayments for services rendered after patients' dates of death.Y... Read more
Reader Questions:
Skip Retrograde Code With 52007
Question: My urologist did a cystoscopy with bilateral retrogrades, right ureteral brush b... Read more
Reader Questions:
Choose Specific Code Instead of Unlisted Whenever Possible
Question: How should I code for a laparoscopic parastomal hernia repair? Which CPT Code ... Read more
Reader Questions:
50845 Captures Stoma Relocation
Question: The patient's Mitrofanoff stoma had stenosed near the bladder end of the stoma. ... Read more
Reader Questions:
26 vs. TC: Send Technical Component to SNF
Question: A patient who is in a skilled nursing facility came to the office for a TRUS, an... Read more
Reader Questions:
Turn to 36415 For In-Office PSA Blood Draw
Question: Is there any way to get paid for an established office visit when a patient come... Read more
You Be the Coder:
10140 or 54015? Let Depth Help Guide Your Coding
Question: Following trauma to the scrotum and penis the urologist performed a scrotal and ... Read more
Case Study:
Tackle Challenging Bladder Tumor, Contracture Procedures With 3 Expert Tips
Remember that payer rules about bladder tumor removal coding vary.When your urologist perf... Read more
ICD-10:
Make Sure You're Ready: Get the ICD-10 Lowdown With Expert Guidelines
You'll need to implement the new 5010 claim form first to be ready for ICD-10. Whi... Read more
Money Matters:
Don't Scrap PQRI If Some of Your Doctors Don't Participate
Plus: Look for 2009 incentive payments this fall, CMS says.If all of your physicians are g... Read more
ICD-10:
Catch a Glimpse at ICD-10 Codes for Hematuria BPH, and More
Get used to using letters in your diagnosis coding.In the previous article, you've learned... Read more
Reader Questions:
Count Lysis of Adhesions in 54163
Question: Would it be appropriate to bill CPT 54163 and CPT 54162 -59? My urologist wants... Read more
Reader Questions:
Check With Payer for Renacidin Drug Pay
Question: Can we be reimbursed for Renacidin in an office setting if the urologist is usin... Read more
Reader Questions:
Different Side Means Separate Lead Removal Coding
Question: My doctor took out an old interstim generator and lead on the patient's right si... Read more
Reader Questions:
Choose Between 25 and 57 Based on Global
Question: My urologist performed a deactivation of an artificial urinary sphincter an... Read more
Reader Questions:
Bill Family Counseling Session Based on Time
Question: My urologist did a counseling session with the parents of a minor regarding the ... Read more
You Be the Coder:
Stricture Excision and End-To-End Anastomosis
Question: The urologist performed a Mercedes-Benz type incision in the perineum and dissec... Read more
CCI 16.2 Update:
Stop Routinely Coding Indwelling Ureteral Stent Insertions, Thanks to CCI 16.2
Plus, CCI solidifies anesthesia coding rules for the attending surgeon. Even during th... Read more
News You Can Use:
Welcome a 2.2 Percent Medicare Pay Boost For the Rest of This Year -- Finally
But the news isn't all good -- first, you faced a week of lower payments, and second,... Read more
Clip and Save:
Ease the Burden of CCI 2010 Round 3 With This Handy Guide to the 16.2 Edits
Save this useful list to help troubleshoot when dealing with these changes. If you get... Read more
Reader Questions:
Submit All Claims to a Contracted Payer
Question: We have a patient who wants us to directly bill her allowable charges for a proc... Read more
Reader Questions:
Collect Surgical Deductibles Up Front
Question: We often have patients who don't pay their deductible after surgery. Is there a ... Read more
Reader Questions:
Select Between 2 Looposcopy and Stent Removal Options
Question: My urologist performed a looposcopy and with a grasping forceps removed the uret... Read more
Reader Questions:
Turn to 38765 for Lymph Node Dissection
Question: My urologist performed a deep inguinal lymph node dissection. I can only find co... Read more
Reader Questions:
Tap 59 for 50650 With 50548
Question: My urologist performed a laparoscopic nephroureterectomy and excision of the dis... Read more
Reader Questions:
Tackle Post-Op Biopsy Complication With Modifier 52
Question: I have a urologist who did a prostate ultrasound and biopsy. After the procedure... Read more
Reader Questions:
Rule Out Coding Without Face-to-Face Encounter
Question: From his office an urologist reviews lab test results and, by telephone, orders ... Read more
You Be the Coder:
Robot-Assisted Lap Fistula Repairs
Question: My urologists are performing Da Vinci robotic laparoscopic vesicovaginal fistula... Read more
Urinary Procedure Coding:
Use 4 Tips to Divert Payment Issues on Your Urinary Diversion Claims
Key: Avoid overcoding accusations and denials when your urologist also performs a cystecto... Read more
Modifier Roundup:
Beware Multiple Surgeon Pitfalls in Urinary Diversion Cases
A quick scan through these guidelines guarantees you'll choose the right modifier for ever... Read more
ICD-9 2011 Update:
Rejoice in Relatively Few Urology ICD-9 Changes This Fall
Additional BMI codes help you get specific for E/M coding. Every October 1, you're... Read more
Evaluation and Management:
Use These Questions to Capture HPI for Full Reimbursement
Get your urologist to collect the information you need with this handy list. In Urolog... Read more
Reader Questions:
Capture Long E/M With +99354
Question: My pediatric urologist spent 105 minutes with a new patient in the office. Is CP... Read more
Reader Questions:
Leave C2625 For Hospitals
Question: Our office wants to start charging for the actual cost of the ureteral stent whe... Read more
Reader Questions:
Skip 52648 for Plasma Vaporizations
Question: Our doctors are starting to do plasma prostate vaporizations. The rep states we ... Read more
Reader Questions:
Self-Circ Repair Doesn't Always Warrant Procedure Coding
Question: A patient performed a circumcision on himself and then came to our office. All m... Read more
Reader Questions:
Unlisted Is Your Only Laparoscopic Cystorrhaphy Option
Question: What code should I use for laparoscopic cystorrhaphy? Alabama Subscriber A... Read more
Reader Questions:
Include Nephrostomy Tube Removal with Stent Placement
Question: What would be the appropriate code for antegrade stent placement with removal of... Read more
Reader Questions:
Choose Diagnosis Based on Documentation, Not Payment
Question: Is there a diagnosis code for fluctuating PSA? The patient's PSA is not really e... Read more
You Be the Coder:
Cysto and Chemical Fulguration with SP Tube Change
Question: My urologist performed a cystoscopic examination because of gross hematuria via ... Read more
Uro-oncology:
3 Tips Help Solidify Your Brachytherapy Coding
Differentiate seeds and markers before choosing 55875 or 55876. Brachytherapy seed placem... Read more
Reimbursement Roundup:
Review Your Lupron Coding and Payments to Ensure Accurate Reimbursement
Your Medicare contractor can't use the least costly alternative payment method anymo... Read more
News You Can Use:
Continue Following Split/Shared Visit Rule, Even Though Consults Are Out
You'll earn 15 percent more billing under your urologist's NPI. Still confused after read... Read more
Reader Question:
Differentiate Simple and Partial Orchiectomy
Question: What is the difference between a simple orchiectomy and partial orchiectomy? I ... Read more
Reader Question:
Get Urodynamics Supply Advice in Writing
Question: We have always reported A4556 for the electrodes our urologist uses during ur... Read more
Reader Question:
No Fragmentation Means No 52353
Question: My urologist performed two ESWLs and stent placement on a nine-year-old patient... Read more
Reader Question:
Skip FB Removal Code for Male Mesh
Question: A male patient underwent surgery involving the excision of a perineal fistulous... Read more
Reader Question:
Save 99238-99239 for 0-Day Globals
Question: My urologist performed a procedure on the 23rd of the month. On the 24th he rev... Read more
Reader Question:
Don't Forget 76942 for US Guidance
Question: How should I report a seminal vesicle biopsy? Oregon Subscriber Answer: You sh... Read more
Reader Question:
Turn to 52354 Without Stricture
Question: My urologist performed a ureteroscopy with laser ablation of ureteral tumor. Th... Read more
You Be the Coder:
Check Documentation For Cath Removal Details
Question: What code can we use for the removal of a urethral/ bladder catheter? Hawaii... Read more
CCI 16.1 Update:
Brace Yourself for Massive Prostate Biopsy, Urethral Dilation Bundlings
Modifier 59 sometimes will rescue your reimbursement. Just when you're finally get... Read more
Confidently Approach SUI Treatment Coding With 4 Pointers
Scan your urologist's documentation for quick clues to 51840 vs. 51841. With several co... Read more
Scope Out Potential Level 4 and 5 E/Ms By Knowing Crucial HPI Facts
Watch out for CPT/Medicare differences when counting HPI elements. If you're not accurate... Read more
Reader Questions:
Unlisted Is the Best Sperm Aspiration Choice
Question: My urologist is performing percutaneous epididymal and/or testicular sperm aspi... Read more
Reader Questions:
Pay Attention to Button TURP Technique
Question: My urologist is performing a new procedure called a "button TURP." I thought CP... Read more
Reader Questions:
Choose BNC Dilation Code Based on Op Note Details
Question: Can I use CPT 52281 for a bladder neck constriction dilation? Florida Subscrib... Read more
Reader Questions:
Capture Kegel Exercise Pay With E/M
Question: Is there a procedure code for billing for Kegel exercise teaching? Can we use c... Read more
Reader Questions:
Count Voiding Diary Toward HPI
Question: Is there a procedure code for reviewing a voiding diary with a patient or is th... Read more
Reader Questions:
Save 52630 for Repeat TURPs
Question: A patient had a TURP 14 years ago and now has a regrowth of his prostate and my... Read more
Reader Questions:
Capture Extra Pay With Modifier 22
Question: My urologist did an open abdominal exploration with cystotomy and removal of ex... Read more
You Be the Coder:
Transplant Nephrectomy, Simple Nephrectomy During Same Encounter
Question: Our doctor removed a transplanted kidney (CPT 50370 ) due to rejection and als... Read more
CPT 2011:
0193T Elimination Will Revise Your SUI Coding for Next Year
Get a glimpse of the codes you'll be using in January so you can prepare now. Janu... Read more
CPT 2011:
99224, 99225, 99226: Get a Handle on Observation Code Changes for 2011
Heads up: You'll have new abdominal/pelvic CPT Codes to use in the new year. Have ... Read more
News You Can Use:
CMS Slashes 2011 Conversion Factor and Wreaks Havoc on Your Pay
Plus: Learn two new HCPCS Codes if your urologist performs wellness visits.Get ready for... Read more
Reader Questions:
52310 vs. 52315: Embedding Makes a Difference
Question: A patient had stones embedded in the prostatic urethra. My urologist used the gr... Read more
Reader Questions:
76080: Don't Miss the Radiology Portion of Fistulogram Coding
Question: How should I code a fistulogram for a patient with a vesicovaginal fistula when ... Read more
Reader Questions:
52648/52649: Skip Modifier 52 Reductions
Question: The urologist ablates tissue from the bladder neck level down toward the verumon... Read more
Reader Questions:
V64.41 Explains Your Lap-to-Open Coding Cases
Question: The urologist performed a laparoscopic mobilization of a kidney but then did an ... Read more
Reader Questions:
52351 Plus 22 Equals Extra Pay for Extra Time
Question: I performed a ureteroscopy; however, I could only advance the scope to approxima... Read more
Reader Questions:
99239: Count All Relevant Time on Discharge Day
Question: The urologist admitted a patient and then discharged the patient five days later... Read more
Reader Questions:
CMS Spells Out MD's Role in E/M
Question: I've heard that for an E/M visit, the physician is responsible for certain parts... Read more
You Be the Coder:
50949: Does Lap Procedure Automatically Mean Unlisted?
Question: I'm trying to decide how to code for a laparoscopic transureteroureterosto... Read more
CCI 16.3 Update:
Incorporate Injury Repair, Diagnostic Laparoscopy Procedure Bundling Into Your Coding Arsenal
Don't forget to look at Category III code bundles, too. Now's the time to add ... Read more
Urogynecology:
3 Tips Unlock the Mysteries of Bladder Scan Coding and Reimbursement
You might be able to report an E/M visit separate from 51798 -- find out how. If ... Read more
Reader Questions:
Don't Miss Cysto Coding With Penile Ring Removal
Question: A patient presented with a penile ring or device that encircled the penis produc... Read more
Reader Questions:
Attach GV or GW to Ensure Hospice Pay
Question: Our urologist performed a dorsal slit for a hospitalized patient on the hospice ... Read more
Reader Questions:
Bilateral Done On 1 Side Means 52
Question: A patient underwent a laparoscopic total pelvic lymph node dissection. The code ... Read more
Reader Questions:
Choose 57311 for Martius Flap Closure
Question: A patient with multiple neurological issues had an indwelling Foley for so long ... Read more
Reader Questions:
Capture Robotic Laparoscopic Bladder Fistula Repair with an Unlisted Code
Question: My urologists are performing DaVinci robotic laparoscopic vesicovaginal fistul... Read more
Reader Questions:
Ask Yourself: Am I in the Global?
Question: We have patients that are in a 90-day global from either TURP or prostate laser ... Read more
Reader Questions:
Limit 55700 to Once Per Encounter
Question: When doing a prostate biopsy, my physician always performs 12 biopsies. The code... Read more
You Be the Coder:
Taking Over Postoperative Care From Another Group
Question: On June 4, 2010 another clinic performed an interstim staged procedure (CPT 6458... Read more
Endourology Case Study:
Capture Full Pay for Multiple Fragmentations With the Truth About Calculi Coding
Hint: You won't always be able to report the procedures in the same order.When your urolog... Read more
Quick Quiz:
Test Your Diagnosis Coding Savvy With This 3-Question UTI, HTN, Suspect Dx Rundown
Find out if you need to hone your diagnosis coding skills.Finding the proper procedure cod... Read more
Back to Basics:
Capture Separate E/M Pay While Avoiding Modifier 25 Scrutiny By Following 3 Golden Rules
Without excellent documentation from your urologist, you'll be forced to skip separate E/M... Read more
Modifier 25 vs. Modifier 57
Your modifier 25 claims should meet all of the following criteria:The E/M occurs on the sa... Read more
Reader Questions:
Skip Temptation to Report 51999 Twice in 1 Session
Question: My doctor did a laparoscopic partial cystectomy and removed the urachal remnan... Read more
Reader Questions:
Add 52204 For Cysto With TURBT
Question: We billed CPT 52224 and CPT 52235 -59 together, but the payer denied 52235 stat... Read more
Reader Questions:
Count Supplies in Nephrostomy Tube Change
Question: What codes should I use for a nephrostomy tube change and a nephrostomy bag?Ariz... Read more
Reader Questions:
Add Modifier 24 For Treatment Discussion During Global
Question: A patient came in for the biopsy report after a 90-day global procedure. The doc... Read more
Reader Questions:
Differentiate Congenital vs. Acquired For Stricture Dx
Question: What is the proper diagnosis code for urethral meatal stricture? New York S... Read more
Reader Questions:
Know the 'String Attached' to Stent Removal Coding
Question: Is there a code for stent removal, by pulling a string, and not through a cystos... Read more
Reader Questions:
No Surgery Doesn't Necessarily Mean No Code
Question: My doctor was going to perform an orchiopexy on a child, but at the time of surg... Read more
You Be the Coder:
Middle Lobe Prostate Vaporization
Question: I am unsure of how to code a transurethral prostate vaporization procedure that ... Read more
Solidify Your +51797 Coding -- and Reimbursement -- With 3 FAQs
Hint: You cannot report this urodynamics code with 51726 anymore. CPT Codes 2010 wreak... Read more
Learn the Ins and Outs of Add-on Codes to Ensure Payable Claims
Use your add-on code savvy to net up to $258 in additional reimbursement. Fortunately, in... Read more
Your Doc Due to Modifier 52, 53 Confusion Stop Shortchanging
Anesthesia, patient well-being can clue you in to the best modifier choice. When your uro... Read more
Reader questions:
Skip Exploration With Excision Coding
Question: Our urologist did a scrotal exploration via an inguinal incision for a parates... Read more
Reader questions:
Attach Two Diagnostic Codes for Cyst Removal Payment
Ques.: My urologist did a vasectomy and removed eight scrotal sebaceous cysts at the sam... Read more
Reader questions:
Support Non-Findings With V65.5
Question: My urologist was called into surgery by an ob-gyn who thought she had injured ... Read more
Reader questions:
Employ 62 for Fistula Treatment Cosurgery
Question: How should I code a resection of a vesicosigmoid fistula? North Carolina Subscr... Read more
Reader questions:
51702 Isn't Just for Nurses
Question: My nurses usually use the CPT 51702 code when they are changing the foley cath... Read more
Reader questions:
Remember All Factors for Post-Op Procedure Coding
Question: A patient had a robotic prostatectomy for prostate cancer on Jan. 1. Then the p... Read more
Reader questions:
Count Seed Removal as Part of Brachytherapy, Sometimes
Question: During an operative session my urologist performed brachytherapy in conjunction... Read more
Reader questions:
Lysis of Adhesions Doesn't Warrant Separate Code
Question: I'm looking for a code for "laparoscopic removal of adhesions between abdominal... Read more
You be the coder:
Is a Modifier Always Necessary?
Question: Our doctor attempted to exchange an externally accessible ureteral stent exitin... Read more
3 Tips Can Help You Overcome SP Tube Placement Coding Challenges
Check anesthesia, approach to clue into 51040 vs. 51102. When your urologist states that ... Read more
Quick Quiz:
Think You Understand the New Consult Rules? Find Out
Test your 2010 consultation coding understanding with these questions. Consultation codin... Read more
Avoid Hospice Coding Headaches With 2 Modifiers
Differentiating between GV and GW is your first step. If your urologist sees and treats h... Read more
Quick Quiz Answers:
Think You Understand the New Consult Rules? Find Out
Check your 2010 consultation coding savvy. Find out if you're set to properly code your u... Read more
Reader Questions:
Employ Modifier 62 for Co-Surgeries
Question: How should I code a resection of a vesicosigmoid fistula? North Carolina Sub... Read more
Reader Questions:
Get Specific With Biopsy Diagnosis
Question: A prostate biopsy reveals "high-grade prostatic intraepithelial neoplasia (PIN-... Read more
Reader Questions:
Collect Your Payment When You Discharge a Patient
Question: Who can bill the CPT 99238 discharge on a Medicare patient? Does it have to b... Read more
Reader Questions:
Learn New Use for KX Modifier
Question: I've heard that Medicare has a new way to override gender-specific edits, ... Read more
Reader Questions:
Cysto + Care Coordination May = Separate E/M
Question: A urologist performs a cystoscopy and then reports the results to the patient o... Read more
Reader Questions:
Know Your Pyelogram Bundling Edits
Question: A physician does a pyelogram on both the left and right side ureter. Can I code... Read more
Reader Questions:
Avoid Reporting +51797 Alone
Question: The physician performs an intra-abdominal pressure study for a patient who is c... Read more
You Be the Coder:
Does Cord Block Rule Out E/M?
Question: Can I report an office visit with a bilateral inguinal cord block? I am being ... Read more
CCI 16.0 Update:
Skip Coding Permanent and Temporary Stents In One Session, Medicare Says
CCI doesn't spare new urodynamics codes, but you can break most bundles. While you... Read more
4 Tips Ensure You Capture Deserved Circumcision Pay
Don't count on extra pay for the nerve block, however. When your urologist perform... Read more
Easily Decipher Between New Vs. Established Using Timing
Hint: Don't focus on the E/M place of service. For every patient your urologist sees for ... Read more
Reader Questions:
Don't Let 'Hand-Assisted' Throw You
Question: To describe lap hand-assisted radical nephrectomy, do we use the laparoscopic p... Read more
Reader Questions:
Report SP Cystostomy Along with Urethra Closures
Question: Our urologist replaced a regular Foley catheter with an open SP cystotomy tube ... Read more
Reader Questions:
Incorporate SP Catheterization in Your Coding
Question: The doctor performed an ultrasoundguided catheter placement via suprapubic appr... Read more
Reader Questions:
Without a Payable Diagnosis, You're Out of Luck
Question: I coded a hand-assisted laparoscopic cryoablation of a renal mass lesion with i... Read more
Reader Questions:
Ensure Separate E/M Service Before Billing
Question: Can I bill Medicare for an office visit and cystoscopy on the same day using a ... Read more
You Be the Coder:
Pare Down Complicated Nephrectomy Coding
Question: My urologist saw a Medicare patient with transitional cell carcinoma of his lef... Read more