Urology Coding and Reimbursement Podcast

By: Mark Painter Scott Painter and Dr. Ray Painter
  • Summary

  • The Urology Coding and Reimbursement Podcast is for Urologists and urology practice staff: Administrators, APPs, Billers and Coders. We help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life. Your cohosts, Mark, Scott and Dr. Ray Painter discuss urology coding and share best practices for the urology office. We will answer submitted urology coding questions so that you can learn the concepts and apply in your practice. Learn the best practices: urology coding, revenue cycle management, scheduling, collections, patient information collection, pre-authorization, prior approval, charge capture, office communications, claim entry review, appeals, audits and billing, that we have tested and proven so you can adapt and incorporate.
    © 2024 Urology Coding and Reimbursement Podcast
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Episodes
  • UCR 211: 2025 cystoscopy code changes and should coders review images attached before submitting charges, or is provider documentation sufficient?
    Sep 13 2024

    September 13, 2024

    Mark, Ray, and Scott discuss questions from the PRS Community.

    1. Hi, In your Urology Times article on July 30th, there is mention of a proposed change to the practice expense component of cystoscopy due to updates in the supply valuation by CPT RVU Update committee. It talks about "packs SA045, SA058 and SA042". What are these packs and can you explain further how this will impact the in-office RVU for CPT 52000?
      thanks
    2. We are looking for some guidance regarding images and the accessibility. When coding procedures such as 50431 (images included in code) or 51600 or 51610 (images billed separately). Does the coder physically need to see the images before submitting charges? Or can charges be submitted if provider clearly documents images available? We know the images are readily available and are attempting to prevent additional work uploading to the chart for coder review. Should we consider having a written policy in place? Appreciate any advice or suggestions y'all may have.


    PRS Billing and Other Services - Book a Call with Mark Painter or
    Marianne Desciose

    Click Here to Get More Information and Request a Quote

    Urology Advanced Coding and Reimbursement Seminars - In-Person Seminars

    Register Now for the Urology Advanced Coding and Reimbursement Seminar

    Click Here for Information and Registration

    Event Details

    Location:
    Las Vegas: December 6-7, 2024, at Horseshoe
    New Orleans: January 31-February 1, 2025, at Harrah's

    Time: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pm

    Includes: Breakfast and Lunch on both days, plus 14 AAPC CEUs


    The Thriving Urology Practice Facebook group.

    The Thriving Urology Practice Facebook Group link to join:

    https://www.facebook.com/groups/ThrivingPractice/


    Join the discussion:

    Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.



    Click Here to Start Your Free Trial of AUACodingToday.com

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    27 mins
  • UCR 210: stent in a pyeloplasty follow-up; G2211 and hypogonadism; and direct supervision requirements
    Sep 6 2024

    September 6, 2024

    Mark, Ray, and Scott address follow-up questions from the previous episode concerning the billability of ureteral stents during procedures. They clarify distinctions between inherent procedural components and separately billable services, emphasizing the importance of documentation.

    The episode also reviews coding for G2211, where Mark adjusts his stance to include hypogonadism for long-term management. Additionally, the hosts discuss the supervision levels required for radiologic services and recommend AUACodingToday.com for efficient coding. Emphasizing up-to-date knowledge and precision in documentation, the episode closes with insights on adapting to evolving coding regulations.

    PRS Billing and Other Services - Book a Call with Mark Painter or
    Marianne Desciose

    Click Here to Get More Information and Request a Quote

    Urology Advanced Coding and Reimbursement Seminars - In-Person Seminars

    Register Now for the Urology Advanced Coding and Reimbursement Seminar

    Click Here for Information and Registration

    Event Details

    Location:
    Las Vegas: December 6-7, 2024, at Horseshoe
    New Orleans: January 31-February 1, 2025, at Harrah's

    Time: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pm

    Includes: Breakfast and Lunch on both days, plus 14 AAPC CEUs


    The Thriving Urology Practice Facebook group.

    The Thriving Urology Practice Facebook Group link to join:

    https://www.facebook.com/groups/ThrivingPractice/


    Join the discussion:

    Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

    Click Here to Start Your Free Trial of AUACodingToday.com

    Show more Show less
    22 mins
  • UCR 209: FAQ -Designated procedure room, -78; stopping a procedure prior to entering OR; and is a stent included in a pyeloplasty?
    Aug 30 2024

    August 30, 2024

    Mark, Scott, and Ray talk about questions that came into the PRS Communities.

    1. Hi, I have a coding question pls. Thanks so much.

      Our urologist performed HIFU a month ago. Pt. had come back for Dysuria postop complication, has been having dysuria for 2 weeks. Our urologist decided to perform Cystoscopy for this.

      Cystoscopy performed, but we did Not bring Pt. back to OR. So, it should Not be a billable service
      But then, Per NCCI, Diagnostic test and procedures may be paid as a separate service during global.

      Should we bill CPT 52000? and If so, will modifier be -58, since it did not occur in OR so -78 would not be an appropriate modifier?
      Please suggest, thank you!
    2. Modifier 73 Question: Can this modifier be used when the patient is in the pre op area and he/she was given Dilaudid and another mediation and then prepped for surgery but then the patient decided they did not want to proceed because the pain medication made them feel better(Patient had a Kidney Stone). It seems resources were used and a block of time was scheduled for the facility. Wording can be a little different from our MAC, CPT, etc when some state the patient has to be taken to the operating room. Thanks for your time.
    3. Hi, We are getting some pushback and would like to know when/if ureteral stents are billable intraoperatively. Our providers are placing a stent, performing pyeloplasty in the same ureter, and the stent is routinely removed one week later.
      Is this stent placement an inherent part of performing the primary procedure, or is this a billable service? Thank you!

    PRS Billing and Other Services - Book a Call with Mark Painter or
    Marianne Desciose

    Click Here to Get More Information and Request a Quote

    Urology Advanced Coding and Reimbursement Seminars - In-Person Seminars

    Register Now for the Urology Advanced Coding and Reimbursement Seminar

    Click Here for Information and Registration

    Event Details

    Location:
    Las Vegas: December 6-7, 2024, at Horseshoe
    New Orleans: January 31-February 1, 2025, at Harrah's

    Time: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pm

    Includes: Breakfast and Lunch on both days, plus 14 AAPC CEUs


    The Thriving Urology Practice Facebook group.

    The Thriving Urology Practice Facebook Group link to join:

    https://www.facebook.com/groups/ThrivingPractice/


    Join the discussion:

    Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.



    Click Here to Start Your Free Trial of AUACodingToday.com

    Show more Show less
    28 mins

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