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Urology Coding Alert

Case Study:
Properly Deciphering Operative Reports Is Key to Correct Payment
Don’t forget to add the proper modifiers. Your urologist’s operative repor... Read more
Payers and Practices Alike Are Reporting Successful Transitions
You may see a small delay in payments. If you’re like most other coders, you wer... Read more
Incident-To Billing:
Understand 'New Problem' Terminology To Accurately Bill Incident-to Services
Check state laws, too. Your urology practice can increase the number of patients you c... Read more
Reader Question:
Focus Your Laparoscopic Ureteral Reimplantation Coding
Question: We performed a robotic assisted laparoscopic distal left ureterectomy, ps... Read more
Reader Question:
Find PFSH To Decide Overall History
Question: I have a urologist’s note for an office visit that clearly indicate... Read more
Reader Question:
Avoid OIG Scrutiny of POS Codes
Question: I have heard that MACs are paying close attention to our place of service... Read more
You Be the Coder:
Location Matters for Complication Treatment Billing
Question: If a patient has a TURP (52601) and 14 days later has urinary retention, ... Read more
Revisit 5 Key Pointers To Ensure You are Set for ICD-10 Success
Remember, family matters to CMS. With the Oct. 1, 2015 ICD-10 implementation date behi... Read more
Move Beyond Implementation, But Don't Stop Training
Continue to stress coder/provider cooperation for success. While you can breathe a si... Read more
Recognize the Positive Impacts ICD-10 Brings to Your Practice
Hard copy resources may make your job easier. Even though Oct. 1 has passed, your prac... Read more
Reader Question:
Indicate 'Path Pending' With D49.5
Question: What ICD-10 code would I use to indicate the pathology is still pending f... Read more
Reader Question:
CMS's Billing Software Won't Eliminate ICD-10 Conversion
Question: I have heard that Medicare has created free billing software that will le... Read more
Reader Question:
Don't Use ICD-9 and ICD-10 on 1 Submitted Claim
Question: Our urologist admitted a patient in September and didn’t discharge ... Read more
Reader Question:
Save 'Unspecified' Codes For Insufficient Documentation
Question: If I find that a common ICD-9 code that I use doesn’t have a direct... Read more
Reader Question:
Check With Your WC Payers Before Using ICD-10
Question: I have heard I won’t use ICD-10 for workers’ compensation rel... Read more
Reader Question:
Get to Know Diabetes ICD-10 Codes
Question: Our practice sees patients with both type I and type II diabetes, but it ... Read more
You Be the Coder:
Stent Removal Diagnosis
Question: What ICD-10 code should I report for the urologist’s work removing ... Read more
CPT® 2016:
Update Your Percutaneous Nephrostolithotomy Coding For the New Year
Stop reporting radiology codes with renal catheter insertions. Labor Day marks the un... Read more
CPT® 2016:
Learn 2 New Penile Trauma Codes
Plus, you’ll have three new urology-related add-on codes in 2016. The 2016 chan... Read more
CPT® 2016:
Pinpoint 2 New E/M Codes You May Use
Stay tuned for reimbursement answers. While there are not many evaluation and managem... Read more
Reimbursement News:
Watch for Potential 2016 Fee Changes That Could Reduce Your Reimbursement
Reversal of some schedule changes could be good for your practice. Code updates aren&... Read more
Get Answers to Top ICD-10 Grace Period Questions
Private payers may not offer the same leeway. With October 1 just around the corner, y... Read more
You Be the Coder:
Looposcopy of Ileal Loop With FB Removal
Question: Can you please help me code the following operative report? POSTOPERATI... Read more
Procedure Primer:
Tackle TURP Coding With 3 Expert Tips
Forget the ‘once in a lifetime’ mantra. While transurethral resection of t... Read more
ICD-10 Quiz Answers:
Test Drive Your ICD-10 Coding Skills With 10 Answers
Find out your weak points now to solve problems before denials roll in. The October I... Read more
Don't Make This Crucial Observation Coding Mistake
Timing is everything when choosing a code. When your urologist admits a patient to obs... Read more
Reader Questions:
Capture Payment for Same-Day Urinalysis, E/M
Question: What is the appropriate modifier to use with 81003 for an automated test ... Read more
Reader Questions:
Don't Stop ICD-10 Prep Based on CMS News
Question: I heard that CMS issued a statement saying we’ll have a one-year re... Read more
Reader Questions:
Use 2 Codes for FNA with Imaging Guidance
Question: My urologist documented that he performed a “transrectal seminal ve... Read more
Reader Questions:
Count the Prosthesis Parts for Coding
Question: What code should I report for a two-piece penile implant? I use 54400 for... Read more
You Be the Coder:
Properly Benchmark Robotic-Assisted Lap Prostatectomy
Question: What is the proper way to code a robotic-assist laparoscopic simple prost... Read more
Case Study:
Shore Up Your Complicated Nephrostomy Tube Removal Coding
Tip: Details matter to ensure proper code selection.  Percutaneous nephrostomy is... Read more
ICD-10 Quiz:
Test Drive Your ICD-10 Coding Skills With 10 Questions
Find out your weak points now to solve problems before denials roll in.  Before l... Read more
Evaluation & Management:
Clear Up MDM vs. Medical Necessity Confusion or Face Denials
Make sure your urologist knows what he is signing when submitting claims. Justifying h... Read more
Reader Questions:
Suture Placement Decides MMK or Burch
Question: I saw your article “Follow This Roadmap to Capture Correct MMK Pay&... Read more
Reader Questions:
Open Placement Changes S/P Tube Coding
Question: How should I report a cystoscopy and SP tube placement? South Dakota Su... Read more
Reader Questions:
Query Urologist for Full Procedure Details
Question: My urologist is going to be performing surgery for an adult patient whose... Read more
Reader Questions:
Consider a Granuloma a Lesion
Question: A patient has a sperm granuloma on the end of his spermatic cord (stump) ... Read more
Reader Questions:
Stricture Location Determines Dx Code
Question: What is the best diagnosis code for a left uretero-intestinal anastomotic... Read more
Reader Questions:
Capture Return-to-OR Pay with 78
Question: A patient had a ureteral reimplant early in the afternoon. Later that eve... Read more
Reader Questions:
CCI Modifier Indicator Has the Final Say
Question: I billed Medicare for 52353,-LT and 52351-RT-59. Medicare denied 52351, s... Read more
Reader Questions:
Post Updated NPPs
Question: Our office is updating our Notice of Privacy Practices (NPP) to include t... Read more
You Be the Coder:
Total Nephroureterectomy Using 3 Separate Surgical Approaches
Question: Our urologist did a cystoscopy and using a Collins knife incised the intr... Read more
Urogynecology Case Study:
Follow this Roadmap to Capture Correct MMK Pay
Modifier missteps could cost you nearly $800. If your urologist documented that he per... Read more
Capture 62.5 Percent With These 3 Modifier 62 Tips
Check the fee schedule to see if you can even use 62 on a code. When your urologist wo... Read more
Update Your MMK-Related Diagnoses This Fall
You’ll have an easy transition with these codes. During the Marshall-Marchetti-K... Read more
Evaluation & Management:
Prepare for E/M Self-Audits By Gathering All the Facts
Review your payer’s comparative billing reports to see where your practice fits. ... Read more
Reader Questions:
Look Beyond CCI Edits
Question: My physician performed an excision of an infected urachal cyst, and then ... Read more
Reader Questions:
Pinpoint Decision for Surgery DOS
Question:  A patient had an office visit (99213) with a 185 diagnosis on Feb. 17. T... Read more
Reader Questions:
Define Whitmore Cocktail to Find the Code
Question:  What code should I report when the urologist administers a “Whitmo... Read more
Reader Questions:
Cystoscopy Matters for 50947
Question: Does code 50948 require cystoscopy with stent placement?  If the urolog... Read more
Reader Questions:
Consult Urologist on Lesion Type
Question: Which code should I report when my urologist documents that he removed a ... Read more
You Be the Coder:
Next-Day Nephrectomy Completion
Question: The surgeon did a partial nephrectomy, and the day after, it was discover... Read more
Pediatric Urology:
Repair Your Hypospadias Procedure Coding With 3 Steps
Focus on initial versus complication first. When your urologist performs a hypospadias... Read more
Secondary Procedures - May or May Not Be Separately Reportable or Reimbursed
14040 — Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mout... Read more
Expect Additional Hypospadias Diagnostic Codes
Make sure you look for the defect location. When your urologist performs a hypospadias... Read more
News You Can Use:
You Can Stick with 59 For Now, CMS Says
CMS is giving software entities time to update their systems. If you are still waiting... Read more
Reader Questions:
Stick with Original Diagnosis for Next-Day Repeat Stent Insertion
Question: A patient had a cystoureteroscopy laser lithotripsy with stent placement.... Read more
Reader Questions:
Choose Artificial Construction Code For Intestinovagioplasty
Question: One of my doctors emailed me about a procedure she has not yet performed but n... Read more
Reader Questions:
Check Technical vs. Professional PVR Components
Question: Can we bill 51798 for a PVR if our physician is at a satellite clinic and... Read more
Reader Questions:
Don't Code for Script Writing
Question: Can I use 99499 to report writing a prescription?  Rhode Island Su... Read more
Reader Question:
Be Sure to Attach GZ With ABN
Question: A Medicare patient came into our practice to see his urologist. The physi... Read more
Reader Question:
Following the Urologist Likely Means Established Patient
Question: We have several new urologists starting with our practice. Some of their ... Read more
Reader Question:
Manual Manipulation Equals E/M Only
Question: My urologist saw a patient with testicular torsion. He was able to manipulate ... Read more
Reader Question:
Check Global Period Before Coding 51040
Question: If a patient has an SP tube placement (51040) and comes in monthly for tu... Read more
Reader Question:
Code Based on Specific Adhesions Location
Question: My urologist performed the following procedure, and the doctor suggested ... Read more
You Be the Coder:
Meatus Resection Coding
Question: My urologist’s operative note states that the physician resected th... Read more
Radiology Roundup:
3 Tips Clear Up Radiology Coding For Urology Practices
Get the scoop on limited vs. complete. Radiological imaging is a given in urology prac... Read more
Get to Know Your ICD-10 Malignant Neoplasm Code Rules
Watch out for metastasis rules. If your urologist treats patients with cancer, you&rsq... Read more
News You Can Use:
Rejoice in SGR Elimination
Decision also means ICD-10 will move forward this year. Unfortunately, it was no April... Read more
Payer Pointers:
Clear Up 6 Common Coding Misconceptions With Advice Direct From NGS
Watch for errors with MDM, X{EPSU}, PQRS, and more. Still looking for modifiers X{EPSU... Read more
Reader Questions:
Pay Attention to Consultation Requirements
Question: A new patient came to see a urologist in our practice to discuss whether ... Read more
Reader Questions:
Carve Out Separate Adrenalectomy Work
Question:  In CPT®, 60545 is the code to report when you excise a retroperitoneal ma... Read more
Reader Question:
Tap XS for Bladder + Urethral Injections
Question: The doctor went in and injected Botox in the bladder wall and then inject... Read more
You Be the Coder:
Capture Bladder Cuff Excision
Question My physician performed a ureteroneocystostomy with bladder cuff excision a... Read more
Scour the Documentation to Avoid Losing $720 on PCNL Procedures
Don’t miss additional reportable procedures that bring in deserved reimbursement. ... Read more
ICD-10 Transition:
Step Up Your ICD-10 Preparation with Testing Dates
Choose acknowledgement or end-to-end testing. Whether your urology practice has been p... Read more
Clip and Save:
Pay Attention to Slight Flu Shot Code Changes for 2015
Even if you only have to report one immunization this year, make sure you won’t fo... Read more
Reader Question:
Cancer Diagnosis Without Biopsy
Question: We have an elderly patient who my doctor doesn’t want to subject to... Read more
Reader Question:
Home in on Urology PQRS Measures
Question: When we report to Medicare, what PQRS measures should we be using now tha... Read more
Reader Question:
Stress HIPAA Compliance at Your Front Desk
Question: I was at my own PCP office, and when I went to stand at check in, there w... Read more
Reader Question:
Check Specialty Designations for Multiple Encounter Billing
Question: I work in a practice that has multiple specialties, including urology. So... Read more
Reader Question:
Pay Attention to Consultation Requirements
Question: A new patient came to see a urologist in our practice to discuss whether ... Read more
You Be the Coder:
Ligation of Accessory Gonadal Vein
Question: I am looking for a code for ligation of accessory gonadal vein and scar a... Read more
Office Procedures:
Follow 4 Steps to Successful Testosterone Pellet Implantation Coding
Get to know your payers’ policies or you may give away part of the service for fre... Read more
Get Specific With UTI Details in the Fall
The unspecified code is probably not going to be good enough in the near future. When ... Read more
News You Can Use:
Take Advantage of HPI/Exam Mixing Allowance for E/M Calculations
Review a clinical scenario to drive the point home. Calculating the level of evaluation a... Read more
Reader Question:
Capture Payment for Emergency Ureteral Repair
Question: I placed a mid urethral sling 57288 on a patient on 1/14/15. This was at ... Read more
Reader Question:
S2900 Won't Likely Earn You Extra Payment
Question: How would I report a robotic-assisted exploration and drainage of a vesic... Read more
Reader Question:
Count Intestinovaginoplasty as an Artificial Construction
Question: My urogynecologist said she is planning to perform an intestinovaginoplas... Read more
Reader Question:
Report the Most Accurate Penile Surgery Code
Question: What would we report for preputioplasty? This is a limited dorsal slit wi... Read more
You Be the Coder:
2 Instillations, 1 Encounter
Question: Can we bill two instillation codes in a scenario with the following documen... Read more
CPT® 2015:
Update Your UroLift® Coding or Face 2015 Denials
New codes 52441, +52442 will be your go-to answers. You haven’t had a code to ac... Read more
Focus on the UroLift® Reimbursement Impact
Determine whether in-office performance is profitable enough for your practice. Now th... Read more
Home in on 1 ICD-10 Code to Support Your UroLift® Claims
One BPH code replaces three come October. When your urologist performs a UroLift® ... Read more
Implement 7 Compliance Strategies To Comply With ACA Requirements
These tips from OIG’s chief medical officer should keep your practice out of the c... Read more
Follow This Compliance Director's Advice
As you use Dr. Taitsman’s advice to create a compliance plan, keep the following q... Read more
Reader Question:
Assignment Doesn't Mean No Patient Pay
Question: We have a patient who is new to Medicare asking why she has to pay anythi... Read more
Reader Question:
Ask Your Payer for PA S&I Clarification
Question: Can a PA read and interrupt a test such as a uroflow and PVR and be paid ... Read more
Reader Question:
Pay Attention to DOS for Secondary Stone Removal
Question: We have a patient who had an ESWL and then came to the urologist’s ... Read more
Reader Question:
Reduce Employee Sickness in Your Office
Question: This time of year we have several employees in the office getting sick. W... Read more
Reader Question:
Patient Error Won't Prevent Timely Filing Issues
Question: Our patient gave us her Medicare card but said Medicare was her secondary... Read more
You Be the Coder:
Open Urethral Biopsy, Cystoscopy at the Same Encounter
Question: Our urologist performed a cystourethroscopy with urethral biopsy. The bio... Read more
Procedure Coding:
Capture Circumcision Compensation With 3 Coding Tips
Scour the documentation to find the ‘proof’ to support your claim. Most ur... Read more
Update Your Phimosis, Balanitis Diagnoses for 2015
Don’t expect a straight 1-to-1 transition. Urologists often perform circumcision... Read more
Global Surgical Package:
Decipher What Global Period Eliminations May Mean to Your Urologist
Be aware of the negative side effects for patients. You read about CMS’s proposa... Read more
Urological Pathology Spotlight:
Expect Less Reimbursement for Prostate Biopsy Pathology Work Next Year
Skip  G0417-G0419 for Medicare. If your urology practice has a histology technici... Read more
Reader Question:
Check With Facility on 2-Provider ER Visit Coding
Question: Our doctor was called into the ER and dictated a consult with the locatio... Read more
Reader Question:
Turn to Unlisted Code for 3D Translabial US
Question: Our urogynecology provider is entertaining the idea of performing 3D tran... Read more
Reader Question:
Stop Looking for V and E Codes in ICD-10
Question: I’ve heard that ICD-10 doesn’t have an equivalent to V codes ... Read more
Reader Question:
Provider-to-Provider Conversations Don't Violate Patient Privacy
Question: Our urologist wants to talk to an oncologist about a patient’s cond... Read more
Reader Question:
'Gonad' Represents a Testicle
Question: What is the proper code for a laparoscopic gonadectomy in a phenotypic (a... Read more
Reader Question:
Stick with 51700 for Clot Irrigation
Question: If a provider does a bladder irrigation through a SP tube for multiple ob... Read more
You Be the Coder:
Robotic Mullerian Cyst Excision
Question: I have a question about coding a robotic excision of Mullerian duct cyst ... Read more