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Urology Coding Alert

Diagnosis Coding:
Determining When 188.x Becomes V10.51 Depends on Exam Findings
Scour your urologist’s documentation for clues. Deciding when to switch from usi... Read more
Stick With 188.x, V10.51 Guidelines in 2014
Deciding which code depends on the documentation. As you read in “Determining Wh... Read more
Diagnosis Coding:
Don't Let Missing Dx Code Thwart Your Urology Claims
Follow three steps to diagnosis coding success. When your urologist forgets to add a d... Read more
News You Can Use:
Jump on the PQRS Bandwagon to Collect Your Bonuses
Plus: Wondering who SMRC is? Here’s the answer. If you still aren’t partic... Read more
Reader Question:
Multiple Seeds Still Means 55876 x 1
Question: How do we report for a gold seed marker placement for future cyberknife radiat... Read more
Reader Question:
Ureteroscopy + ESWL Needs Modifier 58
Question: I bill for an ASC and the surgeon performed a bilateral ureteroscopy then a le... Read more
Reader Question:
Some Payers Say 'No' to Unlisted Codes
Question:My urologist documented a surgery as “robotic assisted bladder diverticul... Read more
Reader Question:
Assess PHI Risk With 6 Questions
Question: I’m always concerned about protecting our patients’ health informa... Read more
Reader Question:
Halt Before Billing Catheter Supply
Question: Can we bill for catheters if the patient couldn’t be catheterized? The p... Read more
Reader Question:
Lysis + Repair = 1 Penile Procedure Code
Question: Are lysis of penile adhesions and repair of penile skin bridge the same proced... Read more
You Be the Coder:
What Diagnosis Is Best for Second Prostate Biopsy?
Question: A patient was diagnosed with prostate cancer in 2012 with a positive prostate ... Read more
CCI 19.3:
Count Ureterolysis as Part of Several Abdominal, Retroperitoneal Surgeries
Don’t forget to check the deletions as well. The last round of Correct Coding I... Read more
Avoid 4 Common ABN Pitfalls With Guidance Straight From Medicare
Bust these myths before your reimbursement suffers. Think you know the ins and outs of... Read more
News You Can Use:
OIG Focuses Its Sights on 'G' Modifiers
Expect extra scrutiny when you use GA, GZ, GY, and GX. When your practice is billing M... Read more
Recovery Audit Contractors:
OIG Wants Action on RAC-Identified Improper Payments
Check your practice for vulnerabilities. If you’ve heard that recovery audit con... Read more
Reader Question:
Turn to Unlisted for Laparoscopic Bladder Takedown
Question:  How would I code for a laparoscopic takedown of a Burch bladder suspensi... Read more
Reader Question:
No Face-to-Face May Mean No Code
Question: My urologist sends patients to the hospital to receive IV antibiotic therapy w... Read more
Reader Question:
POS Matters in Code Order
Question: We are planning our first combined Botox and bulking agent (Macroplastique) on... Read more
Reader Question:
Billing 76700 + 76770? Not So Fast
Question: Can we bill abdominal (76700) and renal ultrasound (76770) together? Please ad... Read more
You Be the Coder:
Determine Exact Testosterone Preparation Before Coding
Question:  How do I code 400 mg of testosterone? Nevada Subscriber Answer: T... Read more
CPT® 2104:
Stop Reporting 52332 With 52353 Starting In January, Thanks to CPT® 2014
A new code will change your cystourethroscopy + lithotripsy + stent coding. Because t... Read more
4 Tips Help Hone Your Modifier 25 Know-How
Haphazardly using 25 on all claims will lead to payer scrutiny. With payers cracking ... Read more
Learn 3 Acceptable Cystoscopy + E/M With Modifier 25 Scenarios
Review these clinical examples that support using 25. There are three clinical scenar... Read more
Correct Coding Initiative:
CCI 19.3 Wreaks Havoc on Your Modifier 25 Claims
Pay attention to CCI bundles before choosing your codes. The newest update to the Corr... Read more
Reader Question:
E/M is Your E-String Reimbursement Answer
Question: How should I code for insertion of an E-string? A urologist of ours is going t... Read more
Reader Question:
Routine PVR Won't Be Billable
Question: Should you bill for a PVR during the global of a 90-day global procedure, like... Read more
Reader Question:
First Round TURP = 52601
Question: If you see a patient who had a laser vaporization of a portion of the prostate... Read more
You Be the Coder:
Focus on the Dx Information You Have
Question: We currently have a situation where urine cytology showed cells positive for h... Read more
Prostate Procedures:
Avoid Repeat TURP Denials By Learning When 52601 Applies -- And When It Doesn't
Know when you need modifiers 58 and 78. Coding the first transurethral resection of p... Read more
Transform Your Polyuria Coding in 2014
Knowing the ‘other’ designation is key. If a patient has polyuria, this me... Read more
Clear Up SNS Placement, Testing Coding Confusion
Pay attention to CCI bundles before choosing your codes. In the Urology Coding Alert V... Read more
3 Steps Pave Your Path to Top NPP Reimbursement
Watch out for supervision requirement pitfalls. In the current economic climate your u... Read more
News You Can Use:
CPT® 2014 Will Bring 329 Changes
Good news: Urology won’t find too many changes. With the second half of 2013 upo... Read more
Reader Question:
Capture Frenulotomy With 54161
Question: My urologist performed the procedure below. What codes can I report? Dia... Read more
Reader Question:
Weigh Urodynamics Pay Based on POS
Question: Our urologist is thinking about doing urodynamics in an ASC. Can you tell me i... Read more
You Be the Coder:
Spinal Manometer Makes a Difference with 51725
Question: Can you use the code 51725 when the urologist uses an asepto syringe, not a co... Read more
CCI 19.2:
Focus on E/M Bundles When Implementing the Next Round of CCI Edits
If you perform NMP22 tests, watch for 86386 bundlings. The Correct Coding Initiative ... Read more
Familiarize Yourself with Forthcoming ICD-10 Coding Conventions
Not everything will be completely new. As Oct. 1, 2014 continues to draw closer, your ... Read more
Solidify Your SNS Removal and Reinsertion Coding
Differentiate infection and hardware failure with specific diagnostic codes. In the Ur... Read more
Determine Where Your Providers Fall in the VBM Penalty Timeline
Your 2014 quality reporting will determine your VBM adjustments for 2016 payments. Jus... Read more
Reader Question:
Reciprocal Coverage Limits Your Coding
Question: Our physician readmitted a patient that was in a global period for a procedure... Read more
Reader Question:
Pinpoint Biopsy vs. Resection
Question: If a patient is having a repeat transurethral resection of a bladder tumor sit... Read more
Reader Question:
Review ICD-9 Basics to Get PUNLMP Code
Question: What ICD-9 code should I use for a bladder cancer pathology report with the di... Read more
Reader Question:
Overcome EPF vs. Detailed Exam Confusion
Question: I am so frustrated with the Palmetto GBA J1 Part B E/M Website because there i... Read more
You Be the Coder:
Include Penile Pump Education in E/M
Question: Is there a code to bill if a patient comes in to learn how to use a penile pum... Read more
4 Tips Help Stimulate Your SNS Reimbursement Success
Capture both lead placement and testing for each step of the process. When convent... Read more
Leave the HPI Details to the Provider, But Leverage Nurse Help When You Can
Identify which portions of the record ancillary staff can capture. Your urologist... Read more
Test Yourself:
Don't Let EMRs Thwart Your Documentation Compliance
Check your skills with identifying compliance pitfalls. In the article “Lea... Read more
Reader Question:
Don't Automatically Combine ER and Office Visits
Question:  If a patient was seen for an office visit (99214) first and then later o... Read more
Reader Question:
Don't Let Patients Give You ABN Hassles
Question: We have a patient who came for a bone density scan we knew Medicare wasn&rsquo... Read more
Reader Question:
Let Patients Know What CO-223 Means
Question: Now that the Medicare remittance is clearly tracking CO-223 for sequestration ... Read more
You Be the Coder:
Surgical Complications May Change Nephrectomy Coding
Question: Can I bill a robotic/laparoscopic partial nephrectomy (50543) plus 50500? Ther... Read more
Case Study:
Don't Let 'Stent' Confusion Sabotage Your Endourology Claims
Hint: You can’t report 52332 whenever your urologist places a ‘stent.’... Read more
Radiology 101:
Watch for Urinary Tract Pathology Exception With Ultrasound Coding
Other limited anatomical reviews won’t support 76770 coding, however. More and m... Read more
Anatomy Basics:
Picture Urologic Anatomy for Better Coding
As a urology coder, you know that urologic radiology focuses on the urinary system. Majo... Read more
Medically Unlikely Edits:
Get to the Bottom of MUE Limitations - And Know When to Fight Back
Bust the myth that you can’t appeal MUE denials. In the Urology Coding Alert Vol... Read more
Reader Question:
Choose 11420 vs. 54050 Series Based on Lesion Type
Question: I have a question regarding removal of a penile lesion. I’m not sure whi... Read more
Reader Question:
Equate 'Submeatal Stenosis' with Stricture
Question: When my urologist documents “cysto with dilatation of submeatal stenosis... Read more
Reader Question:
There Is More Than 1 Way to Document
Question: My urologist reported an established patient office visit code 99214, but the ... Read more
Reader Question:
Follow CMS Regs on Documentation Amendments
Question: Where can I find CMS directions regarding amending documentation? Georgia ... Read more
You Be the Coder:
Called Into the OR? 99251-99255 May Not Apply
Question: How should I code the following procedure: The patient was brought to th... Read more
CCI 19.1:
Skip 49082-49084 With Radical Prostatectomy, Laparoscopic Nephrectomy, and More
Tip: You can override the new edits with a modifier in certain circumstances.  I... Read more
Hone Your Skills with Answers to the Top 3 CCI FAQs
Tip: Keep edits in mind for other payers besides Part B MACs. With new Correct Coding ... Read more
4 Tips Take the Stress Out of Female Incontinence Procedure Coding
Scour the documentation for pertinent details to direct your coding.  Stress inc... Read more
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Compare Documentation to This Handy Chart for Quick Incontinence Procedure Coding
Focus on the surgeon’s approach and location of the sutures. Your urologist or u... Read more
Reader Question:
Combine Same-Day, Same-Patient Inpatient E/Ms
Question: If for a valid reason two of my doctors see the same patient on the same day i... Read more
Reader Question:
52346 Represents Intra-renal Infundibular Stricture
Question: My urologist has performed the following procedure: ·  &n... Read more
Reader Question:
In-Office Cunningham Clamp = A4356
Question: My doctor is giving a patient a Cunningham clamp in the office for incontinenc... Read more
Reader Question:
Hernia Repair Coding Depends on Surgical Method
Question: One my doctors did a laparoscopic prostatectomy with robotic assistance and um... Read more
Reader Question:
Modifier Won't Make Radical Prostatectomy Simple
Question: I need some help coding a laparoscopic simple prostatectomy with extensive lys... Read more
You Be the Coder:
Removal of Ureteral Fungal Ball
Question: How would you code a ureteroscopy with removal of a fungal ball? The pati... Read more
Renal Procedures:
3 Tips Lead the Way to Proper Laparoscopic Nephrectomy + Cyst Ablation Procedures
Scour the documentation for the cyst location.  When your urologist performs sev... Read more
Learn the Basics with this Quick-Glance ICD-9 vs ICD-10 Analysis
Pay attention to placeholders. Make your transition from ICD-9 to ICD-10 easier with ... Read more
Uncover Coding Red Flags with Internal Self Audits
Find errors and compliance issues before an outside auditor does.  Are you confi... Read more
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2 Checklists Help Determine Your Internal Audit Scope and Success
Know your goals and expectations.  If you aren’t quite sure where to begin... Read more
Reader Question:
Choose Just 1 Code for Conversions
Question: My urologist planned to perform an ESWL (50590) on a patient but aborted the p... Read more
Reader Question:
Capture Ureterocele Incision with 52300
Question: Our urologist performed an anesthetic cystoscopy with incision of a left urete... Read more
Reader Question:
No Void = No Code
Question: If a patient is scheduled for a uroflow but cannot void for the flow study, ca... Read more
Reader Question:
Preexisting vs. New Matters During Global Periods
Question: If I see a patient after his radical prostatectomy within the global period, a... Read more
Reader Question:
Low Testosterone Level Leads to 257.2
Question: There is an ICD-9 code for female hormone replacement therapy: V07.4. But is t... Read more
Reader Question:
Benchmark Non-existent Laparoscopy Code to Open Procedure Code
Question: How should I report a robotic/laparoscopic excision of a urachal remnant and r... Read more
You Be the Coder:
Same-Day, Same Patient, Different Doctors, Different Services
Question: Urologist A saw a patient in the hospital as a consultation because he had ure... Read more
Code This!:
Test Your Pelvic Exploration Coding Know-How With This Anastomosis Case Study
Be careful adding stent insertion codes, too.   When your urologist performs a pe... Read more
Watch for ICD-10 Code Additions in National Coverage Determinations
CMS assigns Oct. 1, 2014 as the deadline.  Ever since rumblings of ICD-10 first b... Read more
Evaluation and Management:
Locate 3 Key Pieces of Critical Information Before Coding Based on Time
Key: Don’t rely on ‘I spent more than an hour with the patient’ provid... Read more
3 Tips Improve Your Add-on Code Success
Skip modifier 51 with add-ons.  Often, your urologist will perform a procedure al... Read more
Reader Question:
Dilation Coding Depends on Stricture
Question: My doctor turned in slip that states “patient had cysto with urethr... Read more
Reader Question:
Don't Code Sling Removal Along with Replacement
Question: The urologist performed urethrolysis with excision of an eroded sling and... Read more
Reader Question:
New Patient Visits Require 3 of 3
Question: A new patient presented in our office. Past medical, social, and family h... Read more
You Be the Coder:
Ureteroscopy Plus Lithotripsy Coding
  Question: One of my urologists did a cystoscopy and ureteroscopy with holm... Read more
CCI 19.0:
New Year Brings New CCI Bundles, Many Targeting New CPT® Codes
Pay attention to the modifier indicator to determine which ones you can override and whi... Read more
Get to Know How ICD-10-PCS Will Work
Hint: PCS involves procedure coding, not diagnoses. If your urologist is a private pra... Read more
News You Can Use:
Stop Wondering: Congress Freezes Medicare Pay at 2012 Rates
However, don’t assume your HPSA bonus will continue. As many practices are aware... Read more
Clip and Save:
Avoid Substitute Physician Billing Challenges With These 13 Tips
Be sure you know the difference between modifiers Q5 and Q6. At some point your urolog... Read more
Billing Corner:
Skip Locum Tenens Billing When a New Urologist Isn't Yet Credentialed
Learn how locum tenens actually works before appending Q5 and Q6 whenever you bill under... Read more
Reader Question:
Check Similar Open Procedures for Unlisted Benchmarking
Question: My surgeon performed an excision of a transplant ureter and a pyelovesicostomy... Read more
Reader Question:
Check for Stone Formation in Clot Evacuation
Question: How should I report an open cystotomy with removal of a 7-8cm blood clot? S... Read more
Reader Question:
Report Payers That Don't Accept New Codes
Question: We already have payers that are rejecting the new CPT® codes. They are not... Read more
Reader Question:
School Your Urologist on Legible Medical Records
Question: I have heard payers are cracking down on illegible provider documentation. At ... Read more
Reader Question:
Avoid 'Pricing Modifiers' with Unlisted Procedure Codes
Question: How should we bill for a laparoscopic excision and closure of a colovesical fi... Read more
You Be the Coder:
Explore Pelvic Inspection Coding
Question: I am having trouble coding a procedure. The op report reads as follows: Pro... Read more
Surgical Coding Know-How:
Let 3 Tips Guide You Through the Orchiopexy Procedure Coding Process
If your urologist works with another surgeon, be sure you know when to employ a modifier... Read more
Make the Primary vs. Assistant Surgeon Distinction
    Correction: Make the Primary vs. Assistant Surgeon D... Read more
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Work Your Way Down the Path to Proper Orchiopexy and Hernia Repair Pay
Keep a copy of the handy chart close by to ensure you choose the right codes every time.... Read more
Expand Your Undescended, Retractile Testicle Diagnoses in 2014
Make sure your urologist gets specific in his documentation. When your urologist perf... Read more
Don't Rely on Modifier 59 Alone to Bypass CCI Edits, CMS Says
Key: Get to know modifiers 24 and 57 better. You’ve heard the Correct Coding In... Read more
Reader Question:
50541 Doesn't Differentiate Type of Technology
Question: Is the code for robot assisted laparoscopic renal cyst ablation the same for r... Read more
Reader Question:
CCI Won't Allow 52500 + 52648
Question: My doctor frequently bills 52648 (vaporization of prostate) with 52500 (transu... Read more
Reader Question:
Check Individual Payer Consultation Rules
Question: If my urologist sees a patient in office for say BPH, then he is admitted for ... Read more
You Be the Coder:
When Is a Hydrocele Really a Hernia?
Question: I have a case where the patient is diagnosed with a hydrocele and have heard t... Read more