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Urology Coding Alert

Procedure Focus:
Get Answers to Your Top Lithotripsy Questions
Stay on track by following these four examples. Lithotripsy (50590, Lithotripsy, extracor... Read more
2018 Code Changes:
Watch for These New HCPCS Codes
Two additions might come in handy for your practice. Final changes for HCPCS 2018 have be... Read more
Compliance:
ABN Update Adds New Language to Document
Are you comfortable with the updated ABN? CMS introduced a new ABN (advance beneficiary n... Read more
Reader Question:
Code Multiple Lesion Removals by Largest One
Question: The urologist completed a cystourethroscopy with two lesions removed from differ... Read more
Reader Question:
Plastibell Removal Isn't Coded as Itself
Question: My provider removed a Plastibell in the office. He is not the provider who perfo... Read more
Reader Question:
Look to Z46.6 for Stent Exchange Diagnosis
Question: Our physicians perform ureteral stent exchanges in our ASC quite frequently. The... Read more
Reader Question:
Remember 50081 Is Bundled Into 50561
Question: My physician performed a PCNL to treat a stone in the kidney, then changed to a ... Read more
Reader Question:
Do Not Submit Z90.79 for Post-op TURP
Question: Can you use a diagnosis Z90.79 for a postoperative TURP? Mississippi Subscriber... Read more
Reader Question:
Coding for Partial Urodynamic Study
Question: One of our urologists states she did not do the entire urodynamic procedure and ... Read more
Reader Question:
Don't Submit 54235 During the Same Encounter as 54200
Question:One of our physicians is injecting lidocaine into the patient before he performs ... Read more
Reader Question:
Do You Qualify for New Appeals Guidelines?
Question: I heard that Medicare is putting some new rules for appeals in place. Can you ex... Read more
Reader Question:
Know What '1' Means for Coding Edits
Question: I saw the coding edits for 99221 and 99212 have a modifier indicator of "1." Wha... Read more
You Be the Coder:
Assigning Diagnosis for Eroded Artificial Sphincter
Question: What is the correct diagnosis for an eroded artificial urinary sphincter? Massa... Read more
2018 Coding:
Revisions Will Be Your Biggest Adjustment to 2018 Codes
Updates help clarify what codes truly represent. Urology coders will only have one new ad... Read more
Modifiers 101:
Are You Using Modifier 57 Correctly? Find Out Now
One detail can point you to 57 instead of 25. Every coder knows that appending modifiers ... Read more
E/M Update:
If You File With NGS, Don't Miss This Policy Reversal
Planned change to Expanded Problem Focus, EPF, and detailed exams no longer considered man... Read more
Reader Question:
Submit 55866 for Aborted RALP
Question: It became necessary for the urologist performing a robotic laparoscopic rad... Read more
Reader Question:
Yes, 54512 and 54580 Are Allowed Together
Question: The surgeon created a right/hemiscrotal incision down to the testis. The ap... Read more
Reader Question:
Stent Removal Is Included In a Stent Replacement
Question: The urologist preformed the following: cystoscopy, bilateral stent removal,... Read more
Reader Question:
Code 52234 Represents Thermal Destruction of a Small Bladder Tumor
Question: The surgeon performed thermal destruction of a small bladder tumor. What co... Read more
You Be the Coder:
Bladder Biopsy to Rule Out Cancer
Question: The urologist performed a bladder biopsy to rule out a cancer diagnosis. Sh... Read more
Reimbursement:
Here's Your Heads-up on the Proposed 2018 Physician Fee Schedule
Focus on these 4 areas that might apply to your practice. 'Tis the season for CMS and oth... Read more
Physician Fee Schedule:
Get the Lowdown on Proposed Shifts to 1995 and 1997 E/M Documentation Guidelines
CMS's recently released 2018 proposed Medicare Physician Fee Schedule (MPFS) has caused qu... Read more
Reader Question:
Choose ICD-10 Based on Reason for Advanced Care Planning (ACP)
Question: What ICD-10 codes can I report with 99497 and +99498? I've heard that we ca... Read more
Reader Question:
Code and Bill 55875 for the Urologist
Question: A urology practice is doing radiation therapy for prostate cancer as an off... Read more
Reader Question:
Code 49405 Represents Perinephric Hematoma Aspiration
Question: What are the correct CPT® and diagnosis codes for aspiration of a perineph... Read more
Reader Question:
You Might Not Need Both Pre-and Post-Void Amounts for PVR Urine Test
Question: What documentation must be included in the office note when a PVR test is d... Read more
Reader Question:
New Form Gives Patients Access to Their PHI
Question: It seems that more patients are trying to keep up with their health histori... Read more
Reader Question:
Yes, There Are Ways to Access PHI Through Cloud Storage
Question: Can we access our patients' PHI through cloud storage available from our bi... Read more
You Be the Coder:
Report Multiple Codes for Urethral Diverticulectomy With Cystectomy
Question: I'm coding for a urethral diverticulectomy, cystoprostatectomy, and colon c... Read more
Surgical Coding:
Pinpoint Spot-On Coding for Laser Prostate Procedures
Understand what each code represents to better report the encounter. All laser procedures... Read more
Documentation Tip:
Get Your Physicians to Document More Details Than 'Partial' or 'Complete'
Ensure that you know what they mean by each term. The extent of treatment of prostate gla... Read more
E/M Coding:
Keep Concurrent Claims Clean by Remembering These 5 Guidelines
Track the work of all involved providers to report correctly. Concurrent care occurs when... Read more
Reader Question:
Report 51720 Even for At-Home Voiding
Question: We're in disagreement about which CPT® code to use for BCG bladder instill... Read more
Reader Question:
Steer Clear of +69990 With 55400
Question: My urologist completed a microscopic vasovasostomy, which we normally repor... Read more
Reader Question:
Check Whether Modifier 22 Might Apply to Extensive Case
Question: The urologist placed the ureteroscope to visualize the patient's stone. She... Read more
Reader Question:
Multiple Stones Don't Always Mean Multiple Charges
Question: One of our patients was scheduled for an ESWL (which I would normally code ... Read more
Reader Question:
Some Coders Say You Don't Always Wait on Labs to Report UTI
Question: If a patient has urinary symptoms, our physician orders a dip stick and pre... Read more
Reader Question:
CCI Edits Bundle 60540 Into 50240
Question: The urologist performed a left adrenalectomy and partial upper pole nephrec... Read more
Reader Question:
Get the Lowdown on Exam Levels for Novartis
Question: Our urologist mainly treats patients from New Jersey, but also sees many fr... Read more
You Be the Coder:
Verify Incision Before Filing Your Claim for S/P Tube Removal
Question: What is the correct procedure code for removal of a suprapubic tube? Rhode... Read more
ICD-10:
Prepare for These Changes to Urology Diagnoses in October
There’re might not be many updates, but you’ll be glad to see them. CMS has r... Read more
Diagnosis Coding:
Follow 3 Simple Steps to Diagnostic Coding Success
Don’t let missing diagnoses stall your claim. When your urologist forgets to add a ... Read more
Coding 101:
Hone Your HPI Knowledge in a Flash
Do You Remember the HPI Differences? Quick – you report E/M codes on a regular basi... Read more
Reader Question:
Code 53415 Often Best Choice for Posterior Urethroplasty for Urethral Stricture
Question: What is the correct procedure code for a posterior urethroplasty associated... Read more
Reader Question:
Coding Edits Point You to 51720 Over 52000
Question: A patient came to our office for a surveillance cystoscopic examination for... Read more
Reader Question:
Here's the Difference Between 54900 and 55400
Question: The urologist performed a vasovasotomy (vas reversal) with an epididymovaso... Read more
Reader Question:
Laparoscopic Cystolithopaxy Leads to 'Unlisted' Code
Question: What code should be used for a laparoscopic cystolithopaxy? New Mexico Sub... Read more
Reader Question:
Consider a Modifier with 50590, ESWL for Separate Structure Stones
Question: If the urologist performs an ESWL for a stone in the right ureter and a sep... Read more
Reader Question:
Turn to 53852 for Rezum Treatment
Question: We are trying to find support for reporting 53852 for the Rezum treatment. ... Read more
Reader Question:
Verify Edits Before Billing Ureterolysis with Robotic Partial Nephrectomy
Question: During robotic partial nephrectomy, one of our urologists fully mobilizes t... Read more
You Be the Coder:
Learn the Differences Between Laparoscopic Pelvic Lymphadenectomy Options
Question: I am attempting to understand the issue of laparoscopic pelvic lymphadenect... Read more
Conscious Sedation:
Are You Taking Advantage of the Conscious Sedation Code Changes?
Don’t miss your chances to add this service to your physician’s bill. One wel... Read more
Terminology Refresher:
Remember What Qualifies as Conscious Sedation
Local anesthesia with conscious (or moderate) sedation is safe and effective for patients ... Read more
Modifiers:
Yes, You Can Sometimes Bill for a Cystoscopic Examination With an E/M Service - Do You Know When?
Check out 3 scenarios that may let you append modifier 25 to seal the deal. Submitting a ... Read more
Reader Question:
Begin With 55876 for Gold Seed Marker Placement
Question: Our urologist completed gold seed marker placement in preparation for futur... Read more
Reader Question:
Submit C61 for Second Prostate Biopsy
Question: A positive prostate biopsy led to a patient being diagnosed with prostate c... Read more
Reader Question:
Buccal Graft Excision Takes You From 40818 to 20926 or 15240
Question: My urologist performed a urethroplasty and a buccal graft during the same e... Read more
Reader Question:
Code TURBT From Op Report, Not Path Report
Question: I have a question regarding TURBT. I have been told that I can no longer ge... Read more
Reader Question:
Choose From 3 Options for In-Office Biopsy Code
 Question: What are our best CPT® options when we’re coding for a pros... Read more
You Be the Coder:
Diagnosis for Biochemical Failure
Question: We have a patient who had a radical prostatectomy for prostate cancer four ... Read more
Procedure Focus:
Code Correctly for Undescended Testis Exploration, Orchiopexy
Tip: Watch for chances to submit additional codes. When you code for exploration of undes... Read more
Terminology Check:
Get Familiar With Your Options for Cryptochidism
The scientific name for the absence of one or both testes from the scrotum is cryptorchidi... Read more
Coding Basics:
Let These Scenarios Keep You on Track When Coding Lysis of Adhesions
Look for situations that will allow modifier 22 and boost your pay. Lysis of adhesions mi... Read more
Reader Question:
Indocyanine Green Administration Is Part of Nephrectomy
Question: The urologist administered indocyanine green during a laparoscopic partial ... Read more
Reader Question:
Focus on 52281 for Cystoscopy With Dilation
Question: A patient had a pre-existing pathological urethral stricture. The physician... Read more
Reader Question:
Be Sure to Include Modifier 50 When Bilateral Is Indicated
Question: The urologist scheduled surgery to repair a bilateral ureteral injury. His ... Read more
Reader Question:
Code 54220 Covers Aspiration of Blood From Penis
Question: The urologist placed a needle into the corpora and aspirated blood from the... Read more
Reader Question:
Base Calcification Removal Code on Size
Question: What code can I bill for the removal of skin calcifi­cations from the s... Read more
Reader Question:
Distinguish Between Laser Ablation and Tumor Resection Before Coding
 Question: I am coding for a procedure based on this op note: “The cystosc... Read more
Reader Question:
50230 Can Be Correct Even Without Lymph Node Removal
Question: My doctor performed a robot-assisted nephrectomy that converted to an open ... Read more
Reader Question:
Update ROS Based on Necessity, Not the Calendar
Question: We have some differences in opinion in our office regarding how often we sh... Read more
You Be the Coder:
Code Choices for Cystoscopy and Transurethral Resection of a BNC Release
Question: How do I code a cystoscopy with BNC (bladder neck contracture) release, and... Read more
Procedure Focus:
Know What Differentiates Renal Pelvis Catheter Procedures
Keep these 5 factors in mind as you prepare your claims. Urologists place ureteral stents... Read more
Additional Services:
The Number of Providers Involved Helps Determine Moderate Sedation Choice
Pay attention to who does what. Now that you can report moderate sedation in addition to ... Read more
Inpatient Coding:
Do You Know the Answers to These Common Hospital Questions?
Brush up on your inpatient know-how with 4 everyday scenarios. Coding for hospital E/M se... Read more
ICD-10:
Turn to N20, N21 for Most Calculus Diagnoses
It’s just like real estate: Location is everything. As a urology coder, you see cal... Read more
Reader Question:
Watch Whether Suprapubic Tube Opening Needs a Revision
Question: What CPT® code would be used when a patient is taken back to the OR aft... Read more
Reader Question:
Antibiotic Injection Service Is Part of Cystoscopy Code 52000
Question: We routinely see patients to give them antibiotics via injection prior to c... Read more
Reader Question:
Don't Expect Extra Payment for Indicator L1
Question: We submitted a Medicare claim with 51715 for an endoscopic injection proced... Read more
Reader Question:
Report 'Unlisted' for Urethral Stent Shift
Question: The patient had a stent put in place during a prior procedure a week earlie... Read more
You Be the Coder:
Choosing Between 52317 and 52318
Question: The urologist performed cystoscopy with bladder irrigation and urethral pla... Read more
Procedure Focus:
Keep This Nephrectomy Primer Handy for Your Next Round of Claims
The term “nephrectomy” refers to kidney removal. A nephrectomy might be partia... Read more
ICD-10:
Look for the Type of Obstruction for Hydronephrosis Diagnosis
When the urologist diagnoses hydronephrosis, it means something has happened to cause the ... Read more
Procedure Focus:
'Test Yourself' Answers to Nephrectomy Scenarios
Now that you’ve studied the situations on page ___, here’s how you should repo... Read more
Reader Question:
You Need Multiple Codes for a Cystourethrogram Leading to a Meatoplasty
Question: This male patient had a voiding cystourethrogram revealing a distal meatal ... Read more
Reader Question:
Modifiers Won't Break the 57287and 57288 Edit Bundle
Question: Can we bill for removal of a transvaginal sling and a replacement of a tran... Read more
Reader Question:
Remember Modifier 22 for Multiple Renal Stones in Multiple Locations within a Single Kidney
Question: The urologist scheduled a procedure for a patient who had multiple stones. ... Read more
Reader Question:
Submit S0189 or J3490 for Testosterone Pellets
Question: We use testosterone pellets from a compounder. What is the correct billing ... Read more
Reader Question:
Report 58999 for Excision of Granulation Tissue
Question: The doctor excised granulation tissue on the anterior lip of the cervix. Is... Read more
Reader Question:
Don't Expect Separate Payment for C2625 in an Ambulatory Surgical Center, ASC
Question: Will Medicare reimburse for a ureteral stent when billed by an ASC? We&rsqu... Read more
Reader Question:
Here's Your Scoop on the 60-Day Overpayment Rule
Question: We’ve heard that CMS says we should return any overpayments to federa... Read more
Reader Question:
Decide Between '95 and '97 Guidelines Case-by-Case
Question: Is it true that we can use either the 1995 or the 1997 documentation guidel... Read more
You Be the Coder:
Getting Reimbursed for Botulinum Toxin A for Overactive Bladder: When and How?
Question: The urologist attempted to administer Botox to treat a Medicare patient&rsq... Read more
Therapy Focus:
Dig Into Your 'G' Codes and 'C' Modifiers When Reporting Stress Incontinence Physiotherapy
Forget the ‘G’ code and you’ll be denied. When your urologist orders ph... Read more
Physiotherapy:
Keep 5 Points in Mind When Assigning 'C' Modifiers
7 choices help you pinpoint the patient’s status When you’re coding for a phy... Read more
E/M Coding:
Brush Up on Your HPI Knowledge With These Expert Tips
Count carefully to reach the correct level code. You know that HPI (history of present il... Read more
ICD-10:
Every Detail Counts When Reporting Bladder Neoplasms
Location is your key concern when narrowing the choices. When coding for a patient who ha... Read more
Reader Question:
Learn to Distinguish Between Modifiers 58, 76, and 78
Question: A patient underwent an ESWL of a left renal pelvic calculus with the docume... Read more
Reader Question:
Pre- and Post-infusion Cath Line Care
Question: I need advice regarding how to bill for patients who have a central venous ... Read more
Reader Question:
Splitting Technical/Professional Billing for Urodynamics Is Allowed
Question: I’m unsure how to bill for urodynamics that was performed by a nurse ... Read more
You Be the Coder:
Find Your Best 'Recurrent UTI' Diagnosis for 51798
Question: Medicare plans have been denying our claims for 51798 billed with a diagnos... Read more
CCI Edits:
New Epidural Codes Are a No-Go With Urology Procedures
Plus: You also aren’t able to report moderate sedation separately. The most recent ... Read more
Diagnosis Coding:
Let the Lists and Indices of ICD-10 Boost Your Coding Confidence
You might be surprised by what you’ll find in the instructions. Most coders are fe... Read more
ICD-10:
Don't Miss Whether You Need Extra Codes With Neurogenic Bladder
The related diagnoses might point you to additional options. Neurogenic bladder is a cond... Read more
Reader Question:
Remember: Bill for Two Surgeons Performing Separate Procedures at the Same Encounter
Question: How should we bill for a case done by two surgeons to repair a colovesical ... Read more
Reader Question:
Urinalysis During TURP Post-op Can Be Billable
Question: Our urologists routinely perform urinalysis during the post-op period of TU... Read more
Reader Question:
Look for Clues to Support Unmarked E/M Boxes
Question: Our urologist has what I think is a bad habit of always marking “all ... Read more
Reader Question:
Pay Attention to CCI Edit of 52001 and 52214
Question: A patient underwent evacuation of multiple obstructing clots, which we repo... Read more
Reader Question:
Refresh Your Understanding of 'New' Vs. 'Established'
Question: I’ve heard mixed opinions on the difference between a new and establi... Read more
Reader Question:
Lysis of Spermatic Nerve Adhesions Falls Under 64722
Question: The urologist performed scrotal exploration, lysis of adhesions of the righ... Read more
You Be the Coder:
Know Your Code Choices for for interStim Battery Service
Question: What would the correct CPT® code be for replacing an interStim battery?... Read more
Treatment Focus:
Watch 4 Areas to File Solid Biofeedback Claims
Here’s what you need to know for female stress incontinence. CPT® might include... Read more
Test Yourself:
Reinforce Your Biofeedback Knowledge With 2 FAQs
Remember these situations, simplify your coding. CMS defines biofeedback for urinary inco... Read more
Coding Basics:
Shore Up Your Knowledge of Modifier 53 With These Scenarios
Hint: Timing is everything with this modifier. Adding modifier 53 (Discontinued procedure... Read more
Reader Question:
Procedure and HCPCS Codes for Heparin Injection
Question: A patient was placed in the dorsolitotomy position. After cleansing with be... Read more
Reader Question:
Neonate Circumcision Is 54150 or 54160
Question: It is my understanding that circumcisions done within the 48/96 hour time f... Read more
Reader Question:
Watch Guidelines Before Filing 51045 With 51865
Question: My urologist wants to file a claim with 51045 and 51865. Can we include bot... Read more
Reader Question:
Modifier 52 Could Apply to Lesser Procedure Instead of Radical Prostatectomy
Question: One of our patients was scheduled for an open radical prostatectomy because... Read more
Reader Question:
Don't Be Surprised By Some CMS ICD-10 Denials
Question: Are other coders receiving denials fora PSA claim after 10/1/2016 for using... Read more
Reader Question:
All 'Negative' Notes? Here's How to _______________
Question: Our physician doesn’t check off boxes in the electronic medical recor... Read more
Reader Question:
Consider the Cloud for Your Compliance Solutions
Question: One of my friends who works in HIT is trying to convince us to use “t... Read more
You Be the Coder:
Submit 54620 as the Closest for a Scrotal Approach Orchiopexy
Question: My surgeon performed an orchiopexy via a scrotal approach instead of using ... Read more