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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
ICD-10:
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
Mythbuster:
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
Modifiers:
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
Modifiers:
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
ICD-10:
Transform Your Polyuria Coding in 2014
Knowing the ‘other’ designation is key. If a patient has polyuria, this me... Read more
Urogynecology:
Clear Up SNS Placement, Testing Coding Confusion
Pay attention to CCI bundles before choosing your codes. In the Urology Coding Alert V... Read more
Incident-to:
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
ICD-10:
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
Urogynecology:
Solidify Your SNS Removal and Reinsertion Coding
Differentiate infection and hardware failure with specific diagnostic codes. In the Ur... Read more
PQRS:
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
Urogynecology:
4 Tips Help Stimulate Your SNS Reimbursement Success
Capture both lead placement and testing for each step of the process. When convent... Read more
Documentation:
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
CCI:
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
Urogynecology:
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
Clip and Save:
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
ICD-10:
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
Auditing:
Uncover Coding Red Flags with Internal Self Audits
Find errors and compliance issues before an outside auditor does.  Are you confi... Read more
Clip and Save:
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
ICD-10:
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
ICD-10:
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
Correction:
Make the Primary vs. Assistant Surgeon Distinction
    Correction: Make the Primary vs. Assistant Surgeon D... Read more
Clip and Save:
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
ICD-10:
Expand Your Undescended, Retractile Testicle Diagnoses in 2014
Make sure your urologist gets specific in his documentation. When your urologist perf... Read more
CCI:
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