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Urology Coding Alert

Procedure Focus:
Turn to Documentation to Verify Which TURP Code Applies – if Any
Hint: Pay special attention to the patient’s history. Just because transurethral... Read more
Get to Know the New Modifier That Will Capture Some Telemedicine Services in 2017
Plus: Be sure you are submitting the correct CPT® code as well. As technology evol... Read more
Reader Question:
Get Clear Documentation of US Results Before Reporting 76872
Question: Please share if you think that the following note substantiates a diagnos... Read more
Reader Question:
Report 52005 for Ureter Catheter Placement Through the Cystoscope
Question: A general surgeon asked our urologist to put in ureteral catheters before... Read more
Reader Question:
Is There New Coding for Looposcopy and a Loopogram?
Question: I’m looking for advice on how to bill a looposcopy (stoma access) a... Read more
Reader Question:
Submit A4648 for Each Marker, Not Each Pack
Question: My urologist places markers that come in a kit of three markers in a pack... Read more
Reader Question:
Some Payers Might Not Accept New ICD-10 Codes Until 2017
Question: We’ve been getting denials for claims once we began using the new I... Read more
Reader Question:
E/M Code Could Be Possible Even With Exam
Question: Recently, when coding for an E/M encounter for a follow-up patient, I not... Read more
Reader Question:
Code 76776 Is First Choice for Ultrasound With Doppler
Question: How can we report ultrasound of transplanted kidneys done without duplex Doppl... Read more
You Be the Coder:
Wound Debridement and Wound Vacuum of Abscess
Question: One of our physicians did an incision and drainage of a scrotal abscess o... Read more
CPT® Changes:
Key Into Guideline Updates for Successful Procedure Coding in 2017
Plus: New coding tips also will help keep you on track. In last month’s issue of... Read more
Coding Edits:
Latest CCI Edits Lead You to Double Check Debridement Encounters
But – watch for exceptions to the widespread edit pairs. The most recent versio... Read more
Pinpoint the Reason Behind Urethral Stricture to Code Correctly
Your most common choices will fall in three code families. Urethral stricture is not a... Read more
Reader Question:
Modifier 58 Doesn't Always Require a Trip to the OR
Question: One of our providers will see a patient within the global period for a re... Read more
Reader Question:
Remember All Diagnoses to Fully Report Patient's Condition
Question: I’m coding for a patient who has acute pyelonephritis (Proteus) wit... Read more
Reader Question:
Code 51700 Can Apply for a Voiding Trial With an Existing Catheter
Question: We sometimes have patients come into our office for a voiding trial when ... Read more
Reader Question:
Work of 52310 Includes Basket to Remove Stone
Question: The urologist performed a cystoscopy and used a basket to remove a small ... Read more
Reader Question:
Billing Lymphadenectomy = In Addition to Bilateral Adrenalectomy
Question: The surgeon removed one lymph node during a transabdominal open bilateral... Read more
Reader Question:
Local Anesthesia for Catheter Pain Is Not Separately Billable
Question: Can we bill a 51703 when the provider and/or staff uses glydo jelly as an... Read more
You Be the Coder:
Use This Modifier to Recoup for the Cost of Unused Drugs
Question: We have a consent form that patients sign ahead of procedure, which says ... Read more
Get Ready for Diagnosis Changes for Prosthesis Breakdown and Displacement, Plus More
Hint: Think in terms of encounter status for new revisions. With only a few weeks unti... Read more
CPT® 2017:
Here's Your Scoop on Coding Revisions and Changes You'll Need to Know Next Year
The proposed updates for urology cover numerous common procedures.  The official... Read more
Be Wary of Values for 0-Day Global Procedures Billed With E/M
CMS says some might be misvalued – which could hit your bottom line. According ... Read more
Reader Question:
Lysis of Adhesions Might Not Get a Separate Code, But May Qualify for Modifier 22
Question: Our physician spent about 40 minutes removing adhesions so the patient&rs... Read more
Reader Question:
Submit 'Unlisted' for Seminal Vesicle Exploration and Biopsy
Question: My physician wants to report 49321 for a laparoscopic pelvic exploration ... Read more
Reader Question:
Here's Your Explanation of 'Revision' for 64585
Question: Could you define 64585 for me in terms of what constitutes a “revis... Read more
Reader Question:
Don't Miss the Proper Diagnosis When the Pathology Report Indicates Associated Diagnoses
Question: The urologist performed an open radical cystectomy with a radical prostat... Read more
Reader Question:
Remember Inguinal Hernia Repair Includes Mesh Placement
Question: The surgeon completed an inguinal partial orchiectomy with inguinal herni... Read more
Reader Question:
Keep 4 Categories in Mind for HIPAA Security Issues
Question: We know that any issues that don’t comply with HIPAA regulations ar... Read more
Reader Question:
S3 and S4 Blocks Qualify for Peripheral Block Code 64450
Question: A patient has a neurogenic bladder with refractory urge incontinence and ... Read more
You Be the Coder:
When Modifier 58 Is Not Required for Expected Staged Procedures
Question: The surgeon completed an extensive scrotal and left groin debridement for... Read more
You'll Be Implementing These Code Updates for Prostate Conditions in October
Plus: Infection and inflammatory reaction choices have numerous changes. With the firs... Read more
News You Can Use:
Have You Checked the New Direction for Laparoscopic Cystectomy Coding?
Here’s the latest on how to potentially handle those claims. The American Urolo... Read more
Billing Q&A:
Remember These Points About Licensed Surgical Assistants
Steer clear of reporting E/M services under their names. One of our me... Read more
Reader Question:
Mesh Removal Code Depends on Reason for Condition
Question: The surgeon used an open technique to remove a large amount of mesh mater... Read more
Reader Question:
Yes, You Can Submit 52351 With Other Procedures
Question: I need help with the proper billing for cystoscopy/ureteroscopy. For exam... Read more
Reader Question:
Know Your Code Choices for TURP and TUV
Question: Are there different procedure codes for TURP and TUV (transurethral vapor... Read more
Reader Question:
Check Postoperative Days Status Before Filing a New Claim
Question: A patient is in the postoperative period following a simple prostatectomy... Read more
Reader Question:
Double Check CCI Edits for Services Included in 50947
Question: The urologist completed several procedures during the same operative sess... Read more
Reader Question:
Only Submit 54115 for Deep Foreign Body Removal
Question: A patient with dementia placed numerous key rings around his penis. They ... Read more
Reader Question:
Code 55821 Can Represent Robotic Assisted Simple Prostatectomy
Question: The urologist performed a DaVinci robotic-assisted simple suprapubic pros... Read more
You Be the Coder:
Know How Often to File 52601
Question: One of my doctors completed a TURP for a patient with metastatic cancer w... Read more
Details Make the Difference in Urinary Stent Diagnoses
Here’s your second look at how familiar codes will change in October. The time ... Read more
Procedure Focus:
Follow These 3 Tips for Successfully Coding for Multiple Stones
Pinpoint the location for your first coding clue. Coding for treatment of multiple uri... Read more
Reader Question:
Submit 64722 or 55899, Depending on Payer
Question: The surgeon performed bilateral inguinal incisions and divided the cremas... Read more
Reader Question:
Cystoscopy With Vaginoscopy Lead to 52000 and 57420
Question: The physician performed a cystoscopy and an examination under anesthesia ... Read more
Reader Question:
Code 57311 Covers Urethrovaginal Fistula Closure and More
Question: The urologist performed a transvaginal closure of a urethrovaginal fistul... Read more
Reader Question:
Code 37790 Is Correct for Penile Vein Ligation
Question: The urologist performed a ligation of penile veins. The patient has a his... Read more
Reader Question:
File 54700 for Hematocele Drainage
Question: What is the correct code for incision and drainage of a hematocele? Kan... Read more
Reader Question:
Look to 52317 for Laser Lithotripsy Option
Question: What is the correct procedure code for laser lithotripsy of an impacted 1... Read more
Reader Question:
Should We Use Z00.00 for Normal Exam, Complaint Not Demonstrated?
Question: A patient came to our office with a suspected inguinal hernia, but n... Read more
Reader Question:
Sometimes Modifier 59 Is Better Than XU
Question: The physician ordered a urine culture and an expressed prostatic secretio... Read more
Reader Question:
Remember the Rules for Split Visit Coding
Question: We’re having some debate in our office about how to code for Medica... Read more
Reader Question:
Check Your Choices for Priaprism Takedown
Question: Does CPT® include a code for “priapism takedown” done at ... Read more
You Be the Coder:
Here's the Best Code for Retroperitoneal Lymphadenectomy
Question: A patient had a retroperitoneal lymphadenectomy due to urothelial carcino... Read more
ICD-10 Update:
Prepare Now for What Diagnosis Changes Might Be Coming in October
Start by exploring catheter, genitourinary hemorrhage, and diagnostic imaging updates. ... Read more
Coding Basics:
Be Confident In Distinguishing Modifier 57 from 25
The timing plays an important part. Adding modifiers to your claims can be a simple wa... Read more
Clip 'n Save:
Let These Lists Keep Your 25 and 57 Claims Straight
Check these points to choose correctly. It’s not unusual for coders – or p... Read more
Reader Question:
Diagnosis D49.4 Can Represent a Bladder Lesion
Question: A patient had a cystoscopy during the post-operative global period of a l... Read more
Reader Question:
Submit Multiple Codes for Complicated PCNL
Question: The surgeon did a cystoscopy and retrograde pyelogram to aid in renal acc... Read more
Reader Question:
Steer Clear of 'Open' Codes for Laparoscopic Procedures
Question: Our coders are under the impression that we cannot use “open”... Read more
Reader Question:
Yes, Partial and Radical Nephrectomies Might Be Billable Together
Question: I’m coding for a case where a robotic partial nephrectomy was conve... Read more
Reader Question:
Turn to N31.8 for Neurogenic Bladder Diagnosis
Question: The urologist performed an open suprapubic tube placement and an open ret... Read more
Reader Question:
Only Include N13.2 When Calculus Obstruction Is Present
Question: A patient was diagnosed with a renal stone and hydronephrosis. Can we cod... Read more
Reader Question:
Remember Modifier 51 When Reporting 50220 With 50380
Question: Our surgeon performed a total nephrectomy and then a reimplantation of th... Read more
Reader Question:
Here's Your Primer for Avoiding 'Incorrect Modifier' Denials
Question: Due to staff reduction, I have been recruited into doing some coding. I&r... Read more
You Be the Coder:
Coding for Laparoscopic Cystotomy Repair
Question: I’m coding for the robotic assisted removal of a vaginal mesh and c... Read more
Condition Focus:
Pin Down the Differences With Prostatic Intraepithelial Neoplasia and Have Cleaner Claims
Understanding the different grades is your best starting point. The terminology and di... Read more
Coding 101:
Refresh Your Memory of What's Needed for Successful Payment When Appending Modifier 22
Get clear documentation of the extra work involved. You might only report modifier 22 ... Read more
Aim for More Than 'Unspecified' Diagnosis for Chronic Kidney Disease
You need to know the stage of disease for the most accurate coding. According to the C... Read more
Reader Question:
Check Out This Opportunity to Use Modifier XU
Question: The urologist performed ESWL for a kidney stone and ureteroscopic fragmen... Read more
Reader Question:
Choose 52224 Over 52310 for This Cystoscopy with Stone Excision
Question: During a cystoscopy while our patient was in a post-operative global peri... Read more
Reader Question:
Report 52214 for an Endoscopic Ureteral Orifice, Bladder Cuff Excision
Question: My doctor performed a nephrectomy but before he started it (at the same s... Read more
Reader Question:
Modifier XS Helps Justify Two Ureter Stents
Question: The physician used fluoroscopic guidance to place two stents on the right... Read more
Reader Question:
Submit N42.83 for Prostatic Cyst Aspiration Diagnosis
Question: Is there a CPT® code for aspiration of a prostatic cyst using ultraso... Read more
Reader Question:
File 'Unlisted' for Laparoscopic Cystotomy Repair
Question: The urologist performed a robotic assisted removal of a vaginal mesh from... Read more
Reader Question:
57421 Describes Colposcopy With Biopsy
Question: My physician saw a patient whose bladder had been removed several weeks b... Read more
Reader Question:
Check Both LCDs and NCDs to Your Best Advantage
Question: We have differing opinions in our office about whether we should follow N... Read more
Reader Question:
Put These Modifier Tips to Use
Question: We’ve had some staff reductions, so I have been asked to help with ... Read more
Reader Question:
Check 5 Things to Help Prevent Computer Viruses
Question: We try to stay vigilant about keeping our computers virus free, but know ... Read more
You Be the Coder:
Stent Placement With UPJ Repair
Question: One of my doctors performed a robotic assisted laparoscopic pyeloplasty f... Read more
Coding Edits:
CCI 22.1 Bundles IV Infusions With Numerous Urology Procedures
You might not use the edits, but you’ll want to be aware. With almost 22,000 new... Read more
Procedure Focus:
Don't Let Incorrect Denials Sidetrack Your SNS Coding
Stages and modifiers are your keys to success. Patients sometimes are scheduled for sa... Read more
Terminology Resource:
Knowing the Type of Urinary Incontinence Leads to Better Coding
Keep this list handy to distinguish between the types. Urinary incontinence (the invol... Read more
Don't Miss These Expanded Options for Hydrocele Reporting
ICD-10 takes you from 1 to 4 choices. When your urologist diagnoses a hydrocele (a flu... Read more
Reader Question:
Best Code for Vesicovaginal Fistula Cauterization and Fibrin Injection
Question: During a cystoscopy, my surgeon used a Bugbee electrode via the cystoscop... Read more
Reader Question:
File 64774 for Excision of an Inguinal Nerve Neuroma
Question: The urologist excised a neuroma of an inguinal nerve following an ipsilat... Read more
Reader Question:
Steer Clear of Submitting 50693 With 50080 and 50432
Question: The surgeon performed a left percutaneous nephrosto­lithotomy, an antegrad... Read more
Reader Question:
Multiple Incisions Can Still Mean a Single Code
Question: One of our providers performed what he termed a “hand assisted lapa... Read more
Reader Question:
Follow Documentation Details for Correct Cystotomy Code
Question: The urologist completed an intraoperative consult and then performed a cy... Read more
Reader Question:
Here's How to Handle the Absence of V64.41
Question: What is the current Medicare stance on a laparoscopic procedure converted... Read more
You Be the Coder:
Release of Suburethral Scar Tissue
Question: Our urologist saw a female patient who had urethral stenosis and scarring... Read more
Imaging Procedures:
Refresh Your Knowledge of Renal Imaging
Start by distinguishing ‘complete’ from ‘limited.’ Physicians ... Read more
Terminology Refresher:
Take Note of How 'Ultrasound' and 'Sonogram' Relate
Interchanging the terms doesn’t mean they’re the same. The terms “ul... Read more
Modifier Update:
Remember 3 Things About Modifier 52 on Your Claims
Let these examples guide your usage. Appending modifier 52 (Reduced services) can be ... Read more
Get Specific With the Reason for Urine Retention
Plus: Pay attention to your extra diagnosis choice. When selecting an ICD-10 diagnosti... Read more
Reader Question:
Check Whether You Can Unbundle 50240 and 60540
Question: The surgeon performed a left adrenalectomy and partial upper pole nephrec... Read more
Reader Question:
Verify Abscess Location Before Choosing Between 54700 and 55100
Question: A patient was treated in our office for a scrotal abscess. The surgeon in... Read more
Reader Question:
Site of Service Can Change the Cysto Code
Question: A patient complained of gross hematuria over the past month, seeing actua... Read more
Reader Question:
Let the Approach Determine UPJ Scar Incision Code
Question: How should I code for an incision of a UPJ scar due to ureteral stricture... Read more
Reader Question:
Work of 51595 Includes a Bilateral Pelvic Lymphadenectomy
Question: My physician performed a complete cystectomy for which I know we can file... Read more
Reader Question:
Pathology Doesn't Affect 52234-52240 Selection
Question: Does the pathology report have to be positive for malignancy before we ca... Read more
Reader Question:
Understand When Two-Factor Authorization Comes Into Play
Question: I’ve heard about “two-factor authorization” but don&rsq... Read more
Reader Question:
Count Numbers and Time to Determine Wart Removal Code
Question: Our urologist performed excision and electro-cauterization of multiple ge... Read more
Reader Question:
Remind Physicians of the Latest Signature Requirements
Question: Most of our physicians are very cooperative about all of their documentat... Read more
You Be the Coder:
Coding for Pouchoscopy and Ureteral Stent Removal
Question: What is the best way to code for pouchoscopy with removal of a right uret... Read more
Correct Coding Initiative:
Continue Getting to Know the CCI 22.0 Bundles Affecting Urology
Good news: Most of these pairings will accept a modifier for separate reporting. In t... Read more
Quickly Assign the Right Neoplasm Code By Following These 5 Tips
Look deeper than ‘malignant’ in the documentation. You have been using ICD... Read more
Money Matters:
Stop Losing Money When Patients Miss Their Appointments
Set straightforward expectations and enforce consequences. Scheduled patients who do ... Read more
Reader Question:
Cut Through Lowsley Retractor Coding Challenges
Question: The doctor did a TURP procedure for BPH and LUTS but also did a suprapubi... Read more
Reader Question:
Recoup Foley Catheter Supply Cost
Question: When billing a Foley replacement, are we able to bill for the Foley itsel... Read more
Reader Question:
Stop at 99211 for Nurses
Question: A patient comes in for straight catheter teaching. The nursing staff does... Read more
Reader Question:
Pick Between 2 Options for Ileal Conduit Procedure
Question: Can you help me code this scenario: Preoperative diagnosis: Ileal condu... Read more
You Be the Coder:
Orchiopexy vs. Orchidopexy
Question: I seem to have issues when I try to code for orchidopexies. Is an orchiop... Read more
Correct Coding Initiative:
Consider These CCI Version 22.0 Changes Before Reporting Renal Procedures
Edits focus on updated CPT® codes.  January 1 each year brings not only proce... Read more
Back to Basics:
Ensure You are Correctly Applying CCI Edits With This Primer
Hint: Look beyond Medicare. Whether you’re new to coding or a seasoned urology c... Read more
Modifier FAQ:
Make 'Location, Location, Location' Your Modifier 26 Mantra
If you don’t own the equipment, don’t bill the global code. Most urologist... Read more
Reader Question:
Watch for Medicare Deductible Creep
Question: Can you tell us what the Medicare deductible will be for next year? Kentucky... Read more
Reader Question:
ER Admission Matters to POS
Question: My urologist was performing rounds at the hospital. He got a page that an esta... Read more
Reader Question:
Consider Gerota's Fascia Part of a Radical Nephrectomy
Question: When a urologist does a laparoscopic radical nephrectomy for renal cancer and ... Read more
Reader Question:
Does POS Affect Your Bladder Neck Contraction Dilation Coding?
Question: How should I report a cystoscopy with bladder neck contracture (BNC) dila... Read more
Reader Question:
Let Indiana Pouch Definition Guide Your Coding
Question: My urologist performed an Indiana pouch as a urinary diversion. What code shou... Read more
You Be the Coder:
Procreative Management in ICD-10
Question: We see male patients for possible infertility. At the new patient visit, we do... Read more
Preventive Medicine:
Sort Out PSA Test Codes Based on Screening vs. Diagnostic Purpose
Hint: The diagnosis can point you in the right direction. Prostate specific antigen (P... Read more
Compare Your ICD-10 Options for Stent Removal
Recently a reader contacted Urology Coding Alert and questioned the ICD-10 diagnosis we ch... Read more
2016 Fee Schedule:
Chart Out Your 2016 Expected Reimbursement By Comparing Year-Over-Year RVUs
Use this handy table to prepare for next year. Every new year brings new reimburseme... Read more
HIPAA Compliance:
Knowing What Qualifies as a Breach is Key to Avoidance
Fines range from $100 to $1,500,000 so strive for compliance. Often small mistakes won... Read more
Reader Question:
Take Advantage of the Units Area of Your Claim Form
Question: My physician had to help a general surgeon that was doing an abdominoperineal ... Read more
Reader Question:
Dilation + Replacement = Complicated
Question: We are looking for a CPT® code for cystoscopy and dilatation of suprapubic... Read more
Reader Question:
Sometimes 'Close' Is the Best You Can Do in ICD-10
Question: I have been asked by our pediatric urologist: “what is the proper ICD-10... Read more
You Be the Coder:
Different States Means Add Modifiers
Question: My physicians go to our office in a neighboring state to see patients. There, ... Read more