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Urology Coding Alert

In-Office Testing:
Dodge PSA Coding Snafus By Differentiating Screening From Diagnostic
Let your diagnosis code choice support your claim. While prostate specific antigen (PS... Read more
ICD-10:
Watch For Hematuria Mention to Select the Right Cystitis ICD-10 Code
Encourage detailed documentation for the most specific diagnosis code assignment.  ... Read more
Practice Management:
Review 4 Guidelines to Capitalize on Non Physician Provider Services
Look beyond incident-to billing to shore up your coding and billing. In today’s ... Read more
Reader Question:
Fluoroscopy + ESWL = Denial
Question: When my urologist performs an ESWL, is ultrasound guidance and/or fluoros... Read more
Reader Question:
Cysto Decides 50947 or 50948
Question: How should I code an extravesical ureteroneocystostomy the urologist perf... Read more
Reader Question:
Just 2 Codes Can Capture Complicated Surgery
Question: My urologist noted in a operative report that she performed a radical cys... Read more
Reader Question:
Beware of 'And' Language
Question: I have a physician who wants to bill a paraphimosis reduction. He did thi... Read more
Reader Question:
Tackle No Findings with V65.5
Question: My urologist saw a patient with a suspected infection of an interstim dev... Read more
You Be the Coder:
Ureteral Foreign Body Removal
Question: My doctor performed surgery where “ureteroscopic laser lithotripsy ... Read more
CCI 20.3:
Focus Your Q4 CCI Updates in the Urogynecology Section
You’ll find you can’t report mesh placement with even more procedures. By ... Read more
ICD-10:
Get to Know CMS's ICD-10 Guideline Updates
Some revisions may actually seem very familiar.  Even though you still have anoth... Read more
CPT®reg; 2015:
Get to Know 2 New 2015 Advanced Planning Codes
Pay attention to time documentation for correct use.  If your urologist does advance... Read more
Evaluation and Management:
Implement 4 Tips to Avoid Losing Thousands on E/M Services Every Year
Stay out of the audit crosshairs by avoiding over- and under-coding both. Even if your... Read more
Meaningful Use:
Add an Extra Year to Your Stage 3 Requirement Implementation
You get to choose whether 2011 or 2014 CEHRT works best for your practice. If you&rsqu... Read more
Reader Question:
Avoid Billing Hospital Visits During a 90-Day Global
Question: If my doctor performs a surgery with a 90-day global, and he has subseque... Read more
Reader Question:
Employ Modifier 50 for Bilateral Orchiectomy
Question: A patient had a simple orchiectomy on the right side and on the left side... Read more
Reader Question:
Stick with 52282 for Permanent Stent
Question: I saw your article on new 2015 codes 52441 and 52442. Is there a specific... Read more
You Be the Coder:
Bladder Neck Resection or TURP?
Question: My doctor documented the following: “I had to push the scope throug... Read more
CPT® 2015:
Get to Know the 2015 Cystourethroscopy Changes CPT® Brings
Don’t miss Kock pouch and ileal conduit updates in the surgery section. Although... Read more
Don't Worry About Conversion Factor Changes Yet
There will be a 0 percent update (no change) in physicians fees through 3/31/15. Until t... Read more
CPT® 2015:
Update Your Chronic Care Management Coding Know-How
Pay attention to ‘face-to-face’ changes. While urologists don’t ofte... Read more
Modifiers:
Stop Relying on 59 for All Your Same-Day Bundle Breaking
Get the scoop on four new ‘X’ modifiers before they become mandatory. When... Read more
News You Can Use:
Say Goodbye to Global Periods If CMS Has Its Way
Proposal may pave the way for separate office visit payments. Determining whether you ... Read more
Reader Question:
Fixing Another Surgeon's Injury Means Modifier 52
Question: One of our urologists was called into the OR to do a bladder and ureteral... Read more
Reader Question:
Be Careful Coding 'Off Labeled' Use of Botox
Question: How should I code a Botox injection into uterine outlet? California Sub... Read more
Reader Question:
Watch Out for New FireFly Technology Pitfalls
Question: How would you recommend coding a FireFly partial nephrectomy? My surgeon th... Read more
Reader Question:
Double Work Could Mean Double Pay
Question: My doctor performed lysis of penile adhesions on a patient that is not ci... Read more
You Be the Coder:
Capture Long Office Visit Pay With +99354-+99355
Question: During a scheduled office visit of a new patient, our urologist spent an ex... Read more
Urogynacology Case Study:
Use this Case Study to Shore Up Your Physiotherapy Severity Modifier Coding
Don’t forget to report the non-payable G codes, too. While G8990-G8992 are only ... Read more
ICD-10 News:
Mark Your Calendar, Officially
You have just over a year to prepare.  As you were turning the calendar from July... Read more
Focus on 5 Steps for Successful Vasectomy Coding
Skipping the pre-vasectomy visit coding will cost your practice up to $180.  Vase... Read more
Possible Vasectomy-Related History of Present Illness Notes
If your provider is struggling to document enough history of present illness (HPI) for h... Read more
Reader Question:
Late to the Surgical Party? Try Modifier 52
Question: If a patient had a robotic-assisted laparoscopic hysterectomy (performed ... Read more
Reader Question:
Determine TURP Timing for Correct Coding
Question: My urologist documented the following “At this time we placed a 24 ... Read more
Reader Question:
Fix Fracture Repair Coding with 54440
Question: How do I code this op report: “The penis was degloved, and we notic... Read more
Reader Question:
Check for Double Interpretation Billing
Question: I work in a new ob-gyn practice with a new provider/specialty: a urogynec... Read more
Reader Question:
Check Payer, POS for Clot Evacuation
Question: Can I bill 51700 during the post-operative period of a TURP without a mod... Read more
You Be the Coder:
Periurethral Cyst Removal
Question: Our physician did a cystoscopy with a trans-vaginal removal of a periuret... Read more
CCI 20.2:
Skin Excisions, Urogynecology, E/M Top the July CCI Target List
Good news: Most new edit pairs will allow a modifier. Round three of the 2014 Correct ... Read more
CCI 20.2:
Don't Expect to Capture Payment for G0463 With Urinary Procedures
Facilities will face challenges billing outpatient clinic visits with procedures. Phys... Read more
Clip and Save:
Check If Other Modifiers Apply Before Attaching 59
Save modifier 59 as a ‘last resort’ answer to getting paid.  When you... Read more
ICD-10 Preparation:
7 Steps Help You Continue Improving Documentation to Stay ICD-10 Ready
Stress legibility as well as detailed notes. Every coder knows that documentation is t... Read more
Reader Question:
Pay Attention to Gender For Proper Dilation Coding
Question: Which code should I use for a urethral dilation via a balloon dilator whe... Read more
Reader Question:
Scrap 54440 Without Repair
Question: I need to know the code for penile exploration. The urologist wrote &ldqu... Read more
Reader Question:
Capture Prostate Cystogram with 2 Codes
Question: How should I report prostate cyst aspiration, prostate cystogram, and cys... Read more
Reader Question:
Add Record Review to Your MDM Calculation
Question: A patient had 10 years of medical records sent to our urologist for revie... Read more
You Be the Coder:
When Does an Active Cancer Diagnosis Turn to 'History Of'?
Question: I need a clarification on when to use a history of bladder cancer versus ... Read more
News You Can Use:
Don't Overlook New Modifier 59 Guidance from Some Medicare Contractors
Focus on the word “repeat” for correct coding.  If you are confused b... Read more
Back to Basics:
Don't Let the Alphabet Soup of Operative Reports Thwart Your Coding
Review this primer to hone your acronym decoding skills.  Because of the extended... Read more
Quick Quiz:
5 Sample Notes Help Your Test Your Abbreviation Know-How
Compare your answers to the experts’ to figure out where you need work.  Wh... Read more
Clip and Save:
Tack This Acronym List to Your Wall for Quick Reference
Save time by adding your own internal shorthand to this chart.  We polled our exp... Read more
Reader Question:
No Void = No 51728
Question: My MD is asking if you can bill 51728 if the patient tries to void but is... Read more
Reader Question:
Nail Down Proper HGPIN, PIN, and ASAP Diagnosis Coding
Question: I find prostate diagnoses very confusing, with PIN III and CIS and other ... Read more
Reader Question:
Look to Lab Schedule for 89321 Fees
Question: Since 89321 has no RVU value and carries a zero value, how do I assign an... Read more
Reader Question:
Include Topical Anesthetic in Procedure Billing
Question: One of my doctors is asking if we can bill for the instillation of an ane... Read more
Reader Question:
Turn to Unlisted E/M If Visit Doesn't Match Key Element Requirements
Question: Can I use modifier 52 on 99201 if my provider only captures history and M... Read more
Reader Question:
Different Same-Day Sessions Don't Warrant 59
Question: My doctor saw a patient in the office and performed a cystoscopy (52000).... Read more
Reader Question:
Just Because You Can, Don't Break Every Bundle
Question: Are 54162 and 13131 appropriate coding for a revision of a circumcision w... Read more
You Be the Coder:
2 Codes Portray Lithotomy with Stent + Tube Placement
Question: We had a patient who was taken to the operating room today for left percu... Read more
Endourology:
Unlock Stone + Dilation Procedure Payment With This Case Study Analysis
Tip: Pay attention to dilation approach.  One word can make all the difference in... Read more
ICD-10:
Plan on 1 More Year for ICD-10, CMS Website Says
IPPS reinforces Oct. 1, 2015 date.  Although it was over a month ago that Congres... Read more
Office Guidelines:
Focus on Supervision Requirements Before Employing Ancillary Staff
Overlooking state laws could cost your practice.  If your urology practice, like ... Read more
Urological Oncology:
Confusing FNA and PNB Could Cost You More Than $62 Per Procedure
Don’t assume ‘biopsy’ always means the same thing. When your urologi... Read more
Clip and Save:
Easily Identify the Required Supervision
Remember to make note of tighter state laws.  The Medicare Physician Fee Schedule... Read more
Reader Question:
Count Silver Nitrate as Normal Office Supply
Question: I am trying to find out if there is a HCPCS code to use for billing silve... Read more
Reader Question:
Bill Open Procedure Code For Lap-to-Open Surgeries
Question: My surgeon preformed a laparoscopic radical nephrectomy on a horseshoe ki... Read more
Reader Question:
Complicated Clinical Scenario Doesn't Equate to Complex Coding
Question: Our doctor scoped a patient’s ileal vesicostomy with a flexible sco... Read more
You Be the Coder:
Residual Hydrocele and Foreign Body Granuloma After Vasectomy
Question: My urologist performed a left hydrocelectomy with excision of right sperm... Read more
CCI 20.1:
Focus Your CCI 20.1 Updates on New Code 52356
Good news: You only have a few edits to add to your bundling lists.  The second r... Read more
News You Can Use:
Congress Votes to Halt Your Pay Cuts and Delay ICD-10
Physician associations still plan to pursue a permanent SGR formula revision.  Th... Read more
Quick Quiz Answers:
Check Your ICD-10 Know-How With These 10 Answers
The one-year implementation delay doesn’t mean you should rest on your laurels.&nb... Read more
Reader Question:
Skip 52224 Without Tumor
Question: I read the article titled, “3 Botox Scenarios Help You Navigate You... Read more
Reader Question:
Update Your Zometa Coding for 2014
Question: I heard that the coding for Zometa injections changed in 2014. What shoul... Read more
Reader Question:
Prostate Tissue Biopsy Leads to 55700
Question: What code should I report when my urologist says he performed a “tr... Read more
Reader Question:
Beware the Pitfalls of Outdated Software
Question:  Our IT director said we won’t be able to use Windows XP computers ... Read more
You Be the Coder:
Urethrocutaneous Fistula + Suprapubic Cystotomy
Question: My urologist worked on a patient that showed urethrocutaneous fistula wit... Read more
Case Study:
4 Scenarios Help Hone Your Periurethral Cyst Procedure Coding
Determine the exact clinical circumstances and cyst location before starting your code s... Read more
ICD-10 Quiz:
Test Your ICD-10 Know-How With These 10 Questions
Determine whether you are ready for the October 1 implementation.  With ICD-10 im... Read more
Bilateral Billing:
Overcome Modifier 50 vs. LT/RT Confusion By Researching Payer Policy
Varied policies aren’t just limited to private payers.  There are many proc... Read more
Clip and Save:
Quickly Determine If You Need a Bilateral Modifier With This Chart
Keep this list handy to check your urological surgery codes before attaching 50, LT, or ... Read more
Reader Question:
Interventional Varicocele Ablation Calls for a New Code
Question: How do I code for interventional radiology percutaneous ablation of a var... Read more
Reader Question:
Redocking the Robot Doesn't Equal Separate Codes
Question: I am having a disagreement with one of my doctors, regarding 50548. When ... Read more
Reader Question:
Capture Mitrofanoff Revision Using 52
Question:  How would you code a cystogram, left allograft nephrectomy, ileal augmen... Read more
Reader Question:
Skip 99000 for In-Office UAs
Question:  If we do a urinalysis (UA) dipstick test in the office lab and find an a... Read more
You Be the Coder:
In-Office Post-Op Wound Infection Treatment
Question: We had a patient who was status post bladder sling (still in 90-day globa... Read more
Procedure Know-How:
3 Botox Scenarios Help You Navigate Your 52287 Claims
Learn when you can — and can’t — report a separate procedure. If you... Read more
ICD-10:
Expand Your Cystitis Thinking in October
Documentation of associated conditions will be important. There are many types of cyst... Read more
Correction
In the Vol. 6, No. 2 issue of Urology Coding Alert, the reader question titled “Ch... Read more
Billing Basics:
Implement a No-Show Policy to Keep Your Income Steady Despite Missed Appointments
Focus on all services, not just office visits. Every year it may seem your fight to ma... Read more
Payment Policies:
Don't Count on Payment for 99446-99449
New codes don’t always mean new payment. If you were excited about the CPT® ... Read more
Reader Question:
Complicated Notes Don't Mean Complicated Coding
Question: My urologist had a patient who was status post vasectomy with pain in areas of... Read more
Reader Question:
Check Global Days For Billing Pointers
Question: If a patient has transurethral bulking (51715), goes home with a catheter, ret... Read more
Reader Question:
Benchmark Lap Ureterectomy to 50650
Question: How would you code laparoscopic ureterectomy, psoas hitch, right ureteral reim... Read more
Reader Question:
Meaningful Use Extension Won't Affect ICD-10
Question: Now that Stage 2 of the Meaningful Use requirement has been extended, does tha... Read more
Reader Question:
Scour Report for Details to Decide 10060 vs. 10061
Question: My urologist performed a procedure on a patient with a large symptomatic ingui... Read more
You Be the Coder:
New or Established Patient?
Question: We have a patient who was last seen by our PA on 10/21/11 for abdominal pain. ... Read more
Correct Coding Initiative:
Get to Know the CCI 20.0 Edits Before Your Payers Start Rejecting Claims
New CCI bundles target new 2014 codes. Every Jan. 1 brings code changes, and every new... Read more
Don't miss
There are a few additional bundling edits you should make note of before sending any 201... Read more
CPT® 2014:
Don't Miss Last-Minute CPT® Changes That May Affect Your Coding
Check intro for ‘other qualified health care professional’ clarification. ... Read more
Diagnosis Coding:
Get Specific With Your Diagnosis Coding to Avoid Medical Necessity Denials
Watch for fourth and fifth digit requirements. If you have received a denial stating t... Read more
News You Can Use:
Congress Saves Your Pay From Drastic Cuts - For Now
Hope for SGR fix before April 1. If you were braced for your Medicare reimbursement to... Read more
Reader Question:
Identify Wasted Demerol Portion
Question: I need some help in choosing a J code. We have a Provenge patient that we saw.... Read more
Reader Question:
Give Address Details for Home Visits
Question: If you are billing home visits (99341-99350) the place of service is 12. My qu... Read more
Reader Question:
BPLD Warrants Separate Coding With Cystoprostatectomy
Question: I would greatly appreciate input on the proper coding of the surgery below: ... Read more
Reader Question:
Approach Determines Correct Endopyelotomy Code
Question: My physician did a laser endopyelotomy of the ureter to allow for stent placem... Read more
Reader Question:
Choose 50590 or 52353 for Stone Fragmentation
Question: A cystoscope was used to insert a ureteral stent and a renal calculus was then... Read more
Reader Question:
Be Ready to Prove Your Case with Modifier 82
Question: Is there a difference in the reimbursement of procedures for modifiers 80 (Ass... Read more
Reader Question:
Consider Waiting For Pathology Report to Bill
Question: Benign lesion excisions are not covered by our state Medicaid. We have been lo... Read more
You Be the Coder:
Old Penile Suture Removal
Question: How should I report removal of old sutures of the penis? The patient is a litt... Read more
Urogynecology:
Perfect How You Report Pelvic Floor Muscle Rehabilitation Services
Break down how each type of provider should code for PFMR. Before turning to surgical ... Read more
ICD-10:
Pay Attention to Z33.1 Excludes1 Note
You’ll have just one code to indicate incidental pregnancy status. When a patie... Read more
Evaluation and Management:
Look Beyond the Encounter Documentation to Determine New vs. Established
Tip: Start with the three-year rule. When your urologist sees a patient in the office,... Read more
News You Can Use:
Straighten Up Your Ordering/Referring Process before Jan. 6
Crucial: Make sure your urologist’s enrollment is up to date. Effective Jan. 6, ... Read more
Reader Question:
When Can a Urologist Interpret a Radiological Study?
Question: Can my urologist charge for reading a retrograde urethrocystogram (74450)... Read more
Reader Question:
Determine Direct or General Supervision of a PTNS Service
Question: In your Urology Coding Alert Volume 13, Number 7, there was an article re... Read more
Reader Question:
Urethral Tumor Removal Warrants TURB Code
Question: During a cystoscopy at the end of a brachytherapy case, I noted a urothel... Read more
Reader Question:
Check Reason For Catheter Placement Before Billing
Question: I know that if a urologist is called in to place ureteral catheters for i... Read more
Reader Question:
Decipher the BTA vs. NMP22 Puzzle
Question: In reading the Urology Coding Alert article on NMP22s I have a question. ... Read more
You Be the Coder:
Inability to Dilate a Ureteral Stricture or Remove a Ureteral Stone
Question: A patient was booked for a ureteral stone removal. Per the operative repo... Read more