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Urology Coding Alert

Coding Refresher:
Follow These 4 Tips for Reporting 51701 for Catheter Placement
Starting point: ‘Indwelling' detail helps start you in the right direction. Catheter pl... Read more
Breaking News:
CMS Decides to Implement E/M Changes More Slowly
Staggered approach won't take full effect until 2021. Practitioners across multiple speci... Read more
Get Your Deserved Pay for Modifier 80 Claims
Learn when 80 applies versus 81, 82, and other possibilities. Surgical coding can always ... Read more
Reader Question:
Modifier 50 Replaces LT with RT on Same Claim
Question: Does the code combination 52356 with modifier 50 include placement of stents on ... Read more
Reader Question:
Don't Overlook Possibility of Reporting 55150
Question: A patient has a history of a scrotal wall mass for many years. Recently the mass... Read more
Reader Question:
Not Every TURP Turns Into 52601 or 52204
Question: A patient underwent a procedure to remove ureteral calculi. During the same enco... Read more
Reader Question:
Coding for Laparoscopic Procedure Converted to an Open Procedure
Question: The urologist had to convert a laparoscopic procedure to an open procedure becau... Read more
Reader Question:
Choose Between 51860 and 51865 for Cystotomy Repair
Question: A patient underwent laparoscopic sigmoid resection by a general surgeon. Our uro... Read more
Reader Question:
File 64595 for Sacral Nerve Stimulator Removal
Question: What procedure and diagnosis codes should I use for the removal of a sacral nerv... Read more
You Be the Coder:
Correctly Report Martius Flap Procedure
Question: The urologist completed a Martius flap procedure during the same encounter as a ... Read more
Worried You Won't Get Paid for Sperm Aspiration? Don't Give Up
Other options can help fill the money gap. Urologists often perform sperm aspiration as p... Read more
Diagnosis Focus:
Do You Know the Best Diagnoses for Azoospermia?
Keep these options in mind for success. Azoospermia is the absence of any sperm in the se... Read more
E/M Focus:
Take Advantage of When Time Plays in Your Favor
Choose your E/M coding approach wisely. Many physicians are most comfortable coding their... Read more
Reader Question:
Botox for Bladder Spasms Leads to a Specific CPT® Code
Question: My urologist is injecting botulinum toxin (type A) to alleviate bladder spasms. ... Read more
Reader Question:
Remember Edits Prohibit Reporting 54600 and 54620 Together
Question: The patient underwent a surgical exploration and a detorsion of right testis alo... Read more
Reader Question:
Choose N32.89 for Bladder Erythema
Question: What is the best diagnosis code to report for bladder erythema? I'm deliberating... Read more
Reader Question:
Assign T83.192A for Calcified Ureteral Stent Diagnosis
Question: Can we report 50590 for freeing a calcified ureteral stent? If so, what diagnosi... Read more
Reader Question:
File 50548 for Laparoscopic Total Nephroureterectomy
Question: How should I code for a hand-assisted laparoscopic total nephroureterectomy with... Read more
Reader Question:
Complexity of Procedure Distinguishes 51860 from 51865
Question: A patient underwent laparoscopic sigmoid resection by the general surgeon. Our u... Read more
You Be the Coder:
Coding Prostate Biopsies for Medicare Claims
Question: Medicare denied our claim for prostate biopsies; we billed 14 units of 88305 sin... Read more
Procedure Focus:
Meatotomy Isn't Always Super Simple: Be Sure You're Looking at All Aspects
Tip: Start with checking the patient's age. A meatotomy is a procedure during which the s... Read more
Breaking News:
Get a Sneak Peek at Urology Code Changes for 2019
Don't miss the revision of 74485. The American Medical Association has released its final... Read more
Coding 101:
Get Back to Basics With This Refresher on Consultation Coding
The words ‘transfer' or ‘referral' can be your key to success. In the midst of keepin... Read more
Reader Question:
Submit 'Unlisted' for Excision of Varicose Vein on Scrotal Skin
Question: What CPT® code would I use when the urologist performs an excision of a scrotal... Read more
Reader Question:
Double Check That Multiple Codes Best Cover the Procedures
Question: Our surgeon performed several procedures during a single ASC session: cystoureth... Read more
Reader Question:
No ESWL Means No Reporting 50590
Question: A patient was scheduled for an ESWL in the ASC. She was brought into the operati... Read more
Reader Question:
Turn to 'Unlisted' for Robotic Procedure on Psoas Hitch
Question: A patient was taken to the operating room for robotic exploration and revision o... Read more
Reader Question:
Verify a Substantial Increase in Work with Modifier 22
Question: In reference to varicocelectomy, which is an excision of varicocele or ligation ... Read more
Reader Question:
Report Hematoma Evacuation Based on Depth
Question: Following trauma to the scrotum and penis the urologist performed a scrotal and ... Read more
You Be the Coder:
What's Best to Bill for Laparoscopic Pyeloplasty
Question: One of my doctors performed a robot assisted laparoscopic pyeloplasty and remove... Read more
Lab Testing:
Coding for Urine Culture? Know What Each Choice Represents
Plus: Ensure the diagnosis supports medical necessity. Reporting urine cultures is common... Read more
Proposed Medicare Fee Schedule Could Hit Your Bottom Line Hard
Revamped E/M codes would be a big change. The Medicare Physician Fee Schedule (MPFS) for ... Read more
Reader Question:
10140 Includes Hematoma Drainage and Blood Vessel Ligation
Question: A patient had end-to-end urethroplasty with a buccal mucosal urethroplasty inclu... Read more
Reader Question:
Report 97003 for Iontophoresis to Treat Peyronie Disease
Question: A new physician in our practice wants to perform iontophoresis for Peyronie's di... Read more
Reader Question:
Bladder Exploration Is Part of More Comprehensive Procedure
Question: What procedure code should I use for an open bladder exploration for a diagnosis... Read more
Reader Question:
Get Clear Support Before Reporting 52001 and 52630 on Same Claim
Question: Is it appropriate to unbundle CPT® codes 52001 and 52630 in order to bill both?... Read more
Reader Question:
Cysto Code 50080 Includes Stenting, Lithotripsy, Basket Extraction
Question: The urologist performed several procedures during an operative session: Cyst... Read more
You Be the Coder:
Cyst Unroofing During Radical Nephrectomy
Question: The surgeon planned to perform a partial nephrectomy with unroofing of a renal c... Read more
Coding Update:
Latest CCI Edits Focus on Codes You Might Not Know
Also watch for edit switches involving 57106. The most recent coding edits from the Natio... Read more
Here's Your First Look at Diagnosis Changes for 2019
Hint: You'll have lots more urethral stricture options. The next round of ICD-10-CM chang... Read more
Reader Question:
49321 Best Represents Robotic Exploration of Retroperitoneum
Question: What CPT® codes should I submit for “robotic exploration of retroperitoneum w... Read more
Reader Question:
Modifier Helps Explain Two Separate Nephrectomy Procedures
Question: Our physician performed a partial laparoscopic nephrectomy in the morning. She w... Read more
Reader Question:
Submit Z40.8 for Ureteral Catheter Insertion for Viewing Purposes
Question: A general surgeon asked our urologist to insert ureteral catheters for easier id... Read more
Reader Question:
Skip E/M for Second Visit to Get Test Results if Results are Normal
Question: A patient came to our office for a urodynamics CMG/voiding pressure study. She d... Read more
You Be the Coder:
Office Visit Pay for PSA Screening
Question: Is there any way to get paid for an established office visit when a patient come... Read more
Procedure Focus:
Test Your Prostatectomy Knowledge With These Common Scenarios
Modifiers 51, 52, or 53 might help your cause. Prostatectomy might be a common-enough sur... Read more
Modifier 101:
Follow 4 Tips for Appending Modifier 24 in the Correct Clinical Situations
Remember: It's all about ‘unrelated.' Appending modifier 24 (Unrelated evaluation and m... Read more
Reader Question:
Remember Global Period Rules Before Billing Follow-up Service
Question: A patient had a circumcision, then returned to the OR on the next day for an exp... Read more
Reader Question:
Submit 53899 for Lasering Mesh in Urethra
Question: What procedure code should I use for laser ablation of mesh in the urethra? The ... Read more
Reader Question:
Diagnostic Laparoscopy Could Be 49320
Question: The surgeon planned to perform a laparoscopic robotic sacrocolpopexy but was una... Read more
Reader Question:
Lysis of Penile Adhesions Includes Penile Skin Bridge Work
Question: The urologist documented lysis of penile adhesions and repair of penile skin bri... Read more
Reader Question:
Add Modifier 58 to Second Encounter of Staged Procedure
Question: The surgeon did a first stage PCNL greater than 2cm. The patient returned a week... Read more
Reader Question:
Code 52700 Is for TUR, Not TURP
Question: The surgeon performed a TUR drainage of a prostatic abscess that he said should ... Read more
Reader Question:
Correct Diagnosis for Urethral Stricture Depends on Type, Location, and Etiology
Question: What code (or codes) should I file when my urologist documents “cysto with dil... Read more
Reader Question:
Look to Lesion Type to Choose Between 11424 and 54060
Question: I have a question regarding removal of a penile lesion. I found two code choices... Read more
Reader Question:
Coding for Eroded Sling Removal and Replacement
Question: The urologist performed urethrolysis with excision of an eroded sling. She then ... Read more
Reader Question:
Check Whether You Need a Modifier for NPP Claims
Question: My practice employs both physicians as well as nonphysician practitioners (NPPs)... Read more
You Be the Coder:
Laparoscopic Bladder Removal + Open Ileal Loop
Question: Two urologists worked on a case, but neither was present for the other physician... Read more
Procedure Focus:
Remember These Factors When Coding Orchiectomy
Keep your biopsy options straight as well. An orchiectomy is surgery to remove one or bot... Read more
Pinpoint the Correct Diagnosis for Testicular Biopsy
Get specific with laterality. When you still coded diagnoses based on ICD-9, your options... Read more
Watch for Expansion of Telehealth in Coming Years
The feds continue to promote telemedicine by lessening restrictions. With new codes outli... Read more
OIG Adds Statistical Sampling to Its Work Plan Focuses
The changes could happen in 2019. If you thought claims reviews were getting tougher, you... Read more
Reader Question:
Code Diagnostic Laparoscopy With 49320
Question: The urologist planned to do a laparoscopic robotic sacrocolpopexy, but was unabl... Read more
Reader Question:
Submit 55120 Alone Unless There Are Multiple Incisions
Question: An abscess formed after a patient underwent vasectomy. The urologist performed a... Read more
Reader Question:
Turn to 64425 for Most Orchialgia Treatment Injections
Question: Our physician administered an injection (under general anesthesia) for a patient... Read more
Reader Question:
'Unlisted' Is Your Only Choice for Scrotal Fistula Excision
Question: The urologist completed an excision of a scrotal fistula, scrotal exploration, a... Read more
Reader Question:
Base Tumor Removal Code Choice on Size
Question: What code would be best for resection of a tumor in the urethra? The doctor used... Read more
Reader Question:
Access Point Determines Whether 50961 Is Correct
Question: A patient was diagnosed with a kidney stone and multiple ureteral stones. The ur... Read more
Reader Question:
Removal of a Spermatocele and Partial Removal of Epididymis
Question: The urologist removed the head of the epididymis for an epididymal cyst, a sperm... Read more
You Be the Coder:
Diverticulum of Bladder Diagnosis
Question: Does CPT® include a code for a laparoscopic/robotic bladder diverticulectomy? T... Read more
Procedure Focus:
Watch for These Details When Reporting Varicocele Excision
Plus: Don't confuse varicocele with hydrocele. A varicocele is an abnormal dilation of sp... Read more
Heads Up: Your Diagnosis Choice Can Affect Your Pay
There's more at stake than ever before. Correctly linking a patient's diagnosis code and ... Read more
Don't Forget to Keep Your Physicians and Staff Up-to-Date With HIPAA
It could be time for some refreshers. Just because the physicians and staff in your pract... Read more
Reader Question:
Strike Modifier 91 From Claims When Lab Equipment Fails
Question: Most of our patients havePSA testing once per visit. However, sometimes we have ... Read more
Reader Question:
Getting Denied? Pay Attention to Procedure/Diagnosis Linkage
Question: A Medicare patient is receiving Firmagon and Prolia. If he gets these on the sam... Read more
Reader Question:
Save 53600 for Dilation Without Cystoscopy
Question: If patient has a urethral stricture, and the physician performs sound dilation "... Read more
Reader Question:
Codes 51999 and 44238 Can Be Billed Together
Question: The patient underwent laparoscopic radical cystectomy with ileal conduit diversi... Read more
Reader Question:
Remember 51798 Does Not Have a Global Period
Question: If a patient undergoes a TURP and then 60 days later (during the global period) ... Read more
You Be the Coder:
Check Purpose of Stent Insertion Before Coding for It
Question: The urologist performed cystoscopy, transurethral resection of a bladder tumor, ... Read more
Procedure Focus:
Test Your Bladder Tumor Removal Savvy With 5 Keys to Success
Check your complicated case savvy against the advice from the experts. It's not uncommon ... Read more
Urology Testing:
Be Sure You're Covering Everything During Cystometrograms and Urodynamic Studies
Other studies or services could help build your claim. Urodynamic studies are investigati... Read more
Know Your Diagnosis Options for Urodynamics
Watch the details, because you have a variety to choose from. Many ICD-10 diagnoses can a... Read more
Reader Question:
Bladder Procedure 51798 Can Be Billed After a TURP
Question: A patient underwent a TURP and then 60 days later (during the global period) ret... Read more
Reader Question:
Report 52648 or 52649 for a Laser Repeat Procedure Over 52630
Question: The urologist's surgical note describes laser enucleation with morcellation of t... Read more
Reader Question:
Code Buried Penis Repair With 54300 (Most Likely)
Question: What is the correct code to use for buried/hidden penis repair? Nebraska Subscr... Read more
Reader Question:
Remember Modifier XS for a Separate Organ
Question: The urologist fragmented and extracted a left renal stone and extracted a left u... Read more
Reader Question:
Know Your Modifier Options for Return to Surgery
Question: A patient had outpatient surgery that included lithotripsy (50590) with stent in... Read more
Reader Question:
Don't Bill Visits Without Patient Present
Question: One of our physicians had an office visit with only the patient's family to disc... Read more
You Be the Coder:
Choose This for Ileal Conduit Ureteroscopy
Question: What CPT® code is used when a doctor does a ureteroscopy through an ileal condu... Read more
Procedure Focus:
Adrenalectomy 101: Begin with the Basics to Find Success
Use these real-world examples as your guide. A multitude of questions need answering befo... Read more
Coding Check:
Test Your Real-world Knowledge of Adrenalectomy Coding
How well can you answer these common questions? We gave you three scenarios related to ad... Read more
Surgical Coding:
Follow These 4 Steps for Quick – but Accurate – Vasectomy Coding
Tip: When You should separately code semen analysis Vasectomies can be one of the most co... Read more
Reader Question:
List 52235 as the Primary Surgical Code for TURBT
Question: We billed codes 52224 and 52235 together (appending modifier 59 to 522... Read more
Reader Question:
Code 52315 Represents Complicated Urethral Calculi Removal
Question: Our urologist used grasping forceps to retrieve several stones that were embedde... Read more
Reader Question:
Payer Determines Whether 52310 + 52315 Is Allowed
Question: During an operative session my urologist performed brachytherapy in conjunction ... Read more
Reader Question:
Urodynamics After TVT Can Have Different Coding
Question: If a physician performs urodynamics in the office within the 90 day global perio... Read more
Reader Question:
Do Not Consider 50394 for Involved Nephrostomy Case
Question: A patient presented with previously placed nephrostomy tube and a 3-cm renal pel... Read more
You Be the Coder:
Remember the Overpayment Clock Ticks Is Ticking
Question: If we realize we've received overpayments from CMS, what are the rules for retur... Read more
Radiology Focus:
Follow This Advice the Next Time You Code Bladder Scans
Hint: Don't forget E/M could be allowed with 51798. Trends during the past several years ... Read more
CPT® 2018:
Look How Small Shifts to Observation Codes Could Mean Big Changes for Your Practice
Updates aim to clarify longtime confusion. As you prepared for code changes in 2018, you ... Read more
Don't Miss These MPFS Updates for 2018
E/M and quality measures still rank high in importance. As you get more settled into 2018... Read more
HIPAA Update:
New CMS Tool Verifies Whether You are HIPAA Compliant
Patients and practices can now each check for this information. Increased scrutiny regard... Read more
Reader Question:
Look Beyond 3-year Rule for New vs. Established Patients
Question: What's the difference between a new and established patient in regard to ev... Read more
Reader Question:
Submit 10021 or 10022 for Epididymal Cyst Aspiration
Question: The urologist used ultrasound guidance to evaluate the epididymis and multiple c... Read more
Reader Question:
Skip the Bilateral Modifiers With 52005
Question: I'm seeing multiple posts on coding sites about coding a bilateral retrograde wi... Read more
Reader Question:
Turn to 11004-11006 for Necrotizing Tissue Debridement
Question: I'm coding for the following report: An elliptical incision was made in the righ... Read more
Reader Question:
Verify Details Before Coding Transurethral Unroofing of Prostatic Abscess
Question: The patient was diagnosed with a prostate abscess. What CPT® code(s) should be ... Read more
You Be the Coder:
Differentiate Between Services of 53460 and 52214
Question: A patient's pre-procedure diagnosis was meatal irregular-appearing lesions invol... Read more
Procedure Focus:
Pay Attention to What Separates Cystostomy From Cystotomy
The 's' makes a difference in the surgeon's work. In the urology procedure world, several... Read more
E/M Coding:
Follow This Advice to Collect Inpatient or Outpatient Consultation Dollars
Plus: Remember consultation and referral are different. Consultation and referral coding ... Read more
Clip and Save:
Remember 5 Basics When Coding Consults
Follow the 'R's to success. Before your providers can get paid for consultations, they m... Read more
Reader Question:
Code 57160 Applies to Initial Pessary Insertion
Question: We are looking for clarity regarding an insertion of a pessary, which we normall... Read more
Reader Question:
55700 Is Only Procedure Code for Prostate Fusion Biopsy
Question: Does the CPT® book include codes for a fusion USP/biopsy or a saturation USP/bi... Read more
Reader Question:
Report 51798 for Ultrasound to Check Bladder Volume
Question: My urologist would like me to bill for an ultrasound on the bladder to check vol... Read more
Reader Question:
Documentation of Location Determines M85.88 or I87.8 Diagnosis
Question: What is the best diagnosis for "pelvic calcifications" on radiology scans? The r... Read more
Reader Question:
Understand What Modifier Indicator '1' Means
Question: I was looking up CCI edits for 99221 and 99212, and I saw the edits have a ... Read more
Reader Question:
Follow Payer Guidelines for Whether Adding Tumor Sizes Is Allowed
Question: One of our providers performed a biopsy on the bladder dome, trigone, and prosta... Read more
You Be the Coder:
Tumor Implant Resection With Adrenalectomy
Question: The surgeon completed a laparoscopic adrenalectomy and also completed a resectio... Read more