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Urology Coding Alert

Code Each Level of Service for Proper Reimbursement of Prostatitis Treatment
Prostatitis implies inflammation of the prostate, which may be acute (601.0) or chronic (6... Read more
Case Study:
Gain Pay Up by Coding All Items in Multiple Procedures
Urologists frequently perform more than one procedure during a session, but they may not b... Read more
Modifier -60:
Use When Surgical Field Has Been Altered
CPT 2001 has introduced modifier -60 (altered surgical field), which means that urology ... Read more
Good News:
New Conversion Factor Is $38
Medicares fee schedule for 2001 contains some great news for urologists: a new conversion ... Read more
Correction:
No Separate Billing for CaverMap
In the July Urology Coding Alert, the answer to the reader question Prostatectomy, on page... Read more
Reader Question:
Non-scalpel Vasectomy
Question: How do I code a bilateral non-scalpel vasectomy? What about a reversal?Wisconsin... Read more
Reader Question:
Cystoscopy Through Stoma
Question: When my urologist performs a cystoscopy through a stoma, should I use a regular... Read more
Reader Question:
Penile Doppler
Question: What is the correct code for a penile doppler performed in the office?Florida Su... Read more
Reader Question:
Prostate Freezing Treatment
Question: Under what circumstances can I use the new code for prostate freezing as a cance... Read more
Reader Question:
Prostate Intraepithelial Neoplasia
Question: What is the correct diagnosis code for prostate intraepithelial neoplasia?Indian... Read more
Reader Question:
Failed Vasectomy Reversal
Question: What diagnosis code should I use for a failed vasectomy reversal? Kansas Subscri... Read more
Reader Question:
Multiple Scrotal Cysts
Question: How should I code for multiple scrotal cysts of various sizes? Ohio Subscri... Read more
You Be the Coder:
Converted Nephrectomy
Question: Our urologist encountered problems while performing a laparoscopic nephrectomy, ... Read more
CCI Version 6.3:
Use Modifier -25 to Optimize Reimbursement
Urology coders need to know two main points about the new version of the Correct Coding ... Read more
How to Work With Urodynamics Bundling by Private Payers
Medicare covers multiple urodynamics tests, but some private payers dont. Across the cou... Read more
Understand Coding Rules for 52005 With 52330 and 52332
Urology coders are accustomed to billing for bundled procedures, which require one code ... Read more
New CPT 2001 Codes Improve Reimbursement for Urologists
Urologists who perform sophisticated laparoscopic procedures such as laparoscopic nephrect... Read more
Reader Question:
Resecting Ureteral Stricture
Question: What code should we use for resecting a significantly traumatized ureteral stric... Read more
Reader Question:
Office Vasectomies
Question: We perform vasectomies in the office. How can we be paid a facility fee?Vermont ... Read more
Reader Question:
Laparoscopies
Question: How do physicians bill for a hand-assisted laparoscopic nephrectomy?Connecticut... Read more
Reader Question:
Ureteroscopy
Question: A patient has hematuria. The physician performs a ureteroscopy on the left side ... Read more
Reader Question:
Laceration Repair
Question: How should we code for repair of laceration of corpus cavernosa for penile fract... Read more
You Be the Coder:
Repair of Ureter
Question: How should we code for repair of a ureter that was cut by mistake while a gyne... Read more
Bill 76872 With a Different Diagnosis Code When 76942 and 55700 are Performed on Same Day
"Some payers deny full reimbursement when a transrectal ultrasound is performed the... Read more
Use Modifiers for Unrelated Procedures During Global Period
For proper reimbursement, urologists should use modifiers -24 (unrelated evaluation and ma... Read more
Track Lupron and Zoladex Carefully to Avoid Fraud Claims
The federal investigation into incidents of abuse involving the expensive prostate cancer ... Read more
News Brief:
Fourth Digit Added to Prostate Hyperplasia Diagnosis Codes
Instead of relying on the vague diagnosis code 600 (hyperplasia of prostate) listed in t... Read more
Correction:
Medicare Fee Schedule
In the August 2000 Urology Coding Alert, the insert Payment mistakenly said the Medicare ... Read more
Reader Question:
Catheter Billing
Question: We arent getting paid for any of the catheters we bill Medicare. Can we use the ... Read more
Reader Question:
Postoperative Cystoscopy
Question: A patient had cystoscopy with lithotripsy in the hospital operating room. During... Read more
Reader Question:
Prostate Biopsies and Ultrasounds
Question: Our Medicare carrier does not pay for prostate biopsies and ultrasounds with a d... Read more
Reader Question:
Cystectomy
Question: When I bill 51595 and 43830, the 43830 is denied as being part of 51595. I loo... Read more
Reader Question:
Cystoscopy With Biopsy
Question: How should I code cystoscopy and a needle biopsy of seminal vesicles with prosta... Read more
Reader Question:
Nephrectomy
Question: The physician performed a nephrectomy that was more involved than a simple nephr... Read more
Reader Question:
Cystourethroscopy
Question: Is there a procedure code that can be used when a cystourethroscopy exam is dis... Read more
You Be the Coder:
RITA Procedure
Question: Our physician performs radio-frequency interstitial tumor ablation (RITA). How d... Read more
Use Modifiers to Get Paid for Endoscopic and Open Procedures Performed During Same Session
Urologists frequently wonder if they can bill for an endoscopic and surgical procedure at ... Read more
Boost Reimbursement for Permanent Stent Insertion
Stent insertion 52332 (cystourethroscopy, with insertion of indwelling ureteral stent [e... Read more
Optimize Coding for Spermatic Cord Block
When a patient goes to a urologist complaining of testicular pain, several different thera... Read more
Reader Question:
Biofeedback
Question: We are having trouble getting paid for biofeedback training (90901-90911) and bi... Read more
Reader Question:
Catheter Removal
"Question: What is the correct way to code for removal of a contaminated peritoneal... Read more
Reader Question:
Cystostomy Tube
Question: The urologist did a cystourethroscopy and insertion of cystostomy tube. Two days... Read more
Reader Question:
Ultrasound
Question: What is the code for using ultrasound guidance for percutaneous suprapubic tube ... Read more
Reader Question:
Prostate Cancer Screening
Question: What is the diagnosis code when G0102 is done?New Jersey Subscriber Answer: HCPC... Read more
Reader Question:
Excision of Sperm Granuloma
Question: How do we code for excision of sperm granuloma? CPT 55450 (ligation [percutaneo... Read more
Reader Question:
Cystoscopy
Question: How do you code a cystoscopy with suprapubic catheter incision? Oregon Subs... Read more
Reader Question:
Non-palpable Testis
Question: When caring for a patient with a non-palpable testis in an office exam, I plan f... Read more
You Be the Coder:
Lupron
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Diagnosis Coding Is Key for Reimbursement of PSA Tests
Urologists now can bill Medicare for prostate cancer screening (G0103), but there is som... Read more
Modifier -25 Not Required with Bladder Scan
How do you bill for a bladder scan and an office visit together, and should you use modifi... Read more
Clarification:
Biofeedback Therapy
In the March issue of Urology Coding Alert, the cover article Get Reimbursed for Biofeed... Read more
News Brief:
Code 52332 to Increase by $450
The value of CPT code 52332 (cystourethroscopy, with insertion of indwelling ureteral st... Read more
Reader Question:
Teaching Physicians
Question: Please address the following scenarios regarding the application of HCFAs rule f... Read more
Reader Question:
Codes for Urodynamic Studies
Question: I am trying to optimize coding and reimbursement for urodynamic studies. Current... Read more
Reader Question:
Billing Interureteral Lithotripsy
Question: Does CPT code 52337 include electrohydraulic/(any technique) lithotripsy? ... Read more
Reader Question:
Cancer Consult
Question: A patient with gross hematuria and a history of TCC (transitional cell carcinoma... Read more
Reader Question:
TURP
Question: A TURP (transurethral resection of prostate, CPT code 52601 is started but aft... Read more
Reader Question:
Bladder Neck Contraction
Question: What is the proper code for billing an incision (not resection) of bladder neck ... Read more
Reader Question:
Billing for Antibiotic Sensitivity
Question: We were using CPT code 87184 (sensitivity studies, antibiotic; disk method, pe... Read more
You Be the Coder:
Revision of Sling
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Get Commercial Carriers to Reimburse for Frequent Stent Changes
There are codes for inserting a stent 52332 (cystourethroscopy, with insertion of indwel... Read more
Use a Waiver for Prostatectomy With Bladder Cancer
When it is clinically appropriate to perform a procedure, but there is no way to obtain ... Read more
Case Study:
Coding for Reimbursement of Bilateral Nephrectomy
If that headline gives you pause, its probably because you think a bilateral nephrectomy... Read more
Ultrasound and Office Visits:
You Can Bill for Both
An ultrasound often but not always should be billed with an office visit. Only by knowin... Read more
Optimal Billing for Multiple ESWLs
Physicians who dont bill for a bilateral procedure when it is performed as such are missin... Read more
Reader Question:
Foley Catheter
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Reader Question:
Partial TURP
Question: The doctor performed a cystourethroscopy with bladder biopsies (52204) for carci... Read more
Reader Question:
Echography
Question: A patient came into the office for a bladder post void ultrasound. I billed 76... Read more
Reader Question:
Prostatectomy
Question: My physicians have just started using the new CaverMap device when performing a ... Read more
Reader Question:
Burch Colposuspension
Question: Im trying to code the takedown of a Burch colposuspension. Can you assist me?Tre... Read more
Reader Question:
Stone Burdon
Question: We have a Medicare patient that a large stone. Our doctor states the term is sto... Read more
Optimize Reimbursement for Triple Mix Teaching, Injection and Supply
Urologists who treat patients with triple mix have many billing options and often dont kno... Read more
Coding in the News:
Get Paid for Prostate Cancer Counseling
When the mayor of New York City, Rudolph Giuliani, announced that he had prostate cancer a... Read more
Maximize Pay for Vocare Bladder System
Urologists work with neurosurgoens to treat patients with the Vocare bladder system, and... Read more
Reader Question:
Transvaginal Neurolysis
Question: For transvaginal neurolysis, we have used 53899 (unlisted procedure, urinary sys... Read more
Reader Question:
Urolumen Coding
Question: What is the code for insertion of urolumen for urethral stricture?New York Subsc... Read more
Reader Question:
BCG and Lupron Coding
Question: We do a lot of BCG instillations (51720, J9031) and Lupron injections (96400, J9... Read more
Reader Question:
Modifier -52
Question: A patient has had an inguinal hernia repair preformed at another facility. He p... Read more
Reader Question:
Biopsy and Resection
Question: Can you bill CPT 52601 and 55700 Kansas Subscriber Answer: CPT code 55700 (bio... Read more
Reader Question:
TURBT
Question: How should we code TURBT (transurethral resection of bladder tumor) when there... Read more
Reader Question:
Injections
Question: If you use code 96400 with code J9217 for Lupron injections, would code 96400 al... Read more
You Be the Coder:
Urinary Retention
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Four Steps to Getting Paid for Vasectomies
Vasectomy coding can be complicated by one simple fact: Managed-care companies arent alway... Read more
Optimize Reimbursement For PVRs With 76775
For optimal reimbursement, urologists should use CPT 76775 (echography, retroperitoneal [... Read more
Coding in the News:
New York Mayor Giuliani Urges PSA Screening
When the mayor of New York City, Rudolph W. Giuliani, who is running against Hillary Cli... Read more
Clarification:
Lupron is Covered by Medicare
The story Medicare Reimburses for Zoladex, Not Lupron on page 28 of the April 2000 issue o... Read more
Reader Question:
Complication After Surgery
Question: What modifier should we use on an evaluation and management (E/M) service for a ... Read more
Reader Question:
Global Periods
Question: Do radioactive prostate seed implants and debridement (major) for Fournieres gan... Read more
Reader Question:
IVP and KUB
Question: What codes should we use for intravenous pyelography (IVP) and kidney, ureter, b... Read more
Reader Question:
Uroflow
Question: Please provide a list of recommended CPT codes for biofeedback and an appropria... Read more
Reader Question:
Stents
Question: Could you please tell me how to code for these procedures and get paid by Medica... Read more
Reader Question:
Pre-renal Education
Question: How could we bill for the pre-renal education for the dietitian? My understandin... Read more
Optimize Reimbursement for the Collagen Skin Test
When a urologist plans to inject collagen in the area of the urethra to solve incontinence... Read more
Increase Pay Up for Catheterization
There is some confusion about the correct way to bill for catheterization. Many coders b... Read more
In Brief:
Optimal Coding for Hydrocele Ligation
There is a code for the excision or removal of a hydrocele, a sac filled with fluid that i... Read more
Medicare Reimburses for Zoladex, Not Lupron
Occasionally, a prostate cancer patient will be in a hospice program but seen by his urolo... Read more
Correction:
Modifier -78, Prostate Biopsies
In the February 2000 issue of Urology Coding Alert, in an article titled Maximize Pay Up... Read more
Reader Question:
Modifier -57
Question: What are the criteria for using the -57 modifier? We have been using a -57 (deci... Read more
Reader Question:
Coding Urodynamics
Question: We have just started billing urodynamics and Im running into some rejections. I ... Read more
Reader Question:
Urodynamic Evaluations
Question: We perform office urodynamic evaluations. We perform the Marshall-Marchetti-Kran... Read more
Reader Question:
Unusual Procedures
Question: A patient presents with bilateral renal masses. The mass on the left was removed... Read more
You Be the Coder:
Exploration of Suprapubic Space
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Get Reimbursed for Biofeedback for Incontinence
The key to reimbursement for biofeedback treatment is the work you must do prior to the bi... Read more
Cut the Confusion:
Billing for Retrograde Pyelogram
Urology coders are often confused about what codes they can bill with 52005 (cystourethr... Read more
Correctly Coding Sonograms
When a urologist wants to look at the prostate via sonography, and then also wants to do... Read more
Get Paid for Numerous Consultation Visits
A patient may be referred to a urologist several times for different reasons. Urology code... Read more
Billing for 54235:
Check with Your Payer First
Many urology coders wonder how frequently they can bill 54235 (injection of corpora caver... Read more
Reader Question:
Digital Rectal Exam and E/M Code
Question: Can we bill for a digital rectal exam and an E/M code?Anonymous Maryland Subscri... Read more
Reader Question:
Vasectomy Referral
Question: If a patient asks his primary-care doctor about a vasectomy and is referred to a... Read more
Reader Question:
Ureteroscopy and Stent Insertion
Question: We are unsure whether we can bill a ureteroscopy and stent insertion separately... Read more
Reader Question:
Entrapped Catheter
Question: What ICD-9 diagnosis code should we use for entrapped obstructed Foley cathete... Read more
Reader Question:
Cystometrogram
Question: Our clinic bills the following procedure codes for cystometrograms (CMGs): 51726... Read more
Reader Question:
Express Prostate Massage
Question: One of the physicians in my practice does express prostate massage. When I asked... Read more
Reader Question:
BCG Instillations
Question: We do a lot of BCG instillations (51720, J9031) and Lupron injections (96400, J9... Read more
Reader Question:
Consultations
Question: A patient is referred by his primary-care physician to Dr. A, a urologist. The p... Read more
Reader Question:
Emergency Room Physician
Question: If a patient is referred to me by an emergency room physician, can I bill for a ... Read more
You Be the Coder:
Stent Removal
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Optimize Reimbursement for Multiple Procedures Involving Related Endoscopies
Multiple procedures do not necessarily mean multiple payments from carriers, particularly ... Read more
Maximize Pay Up for Same Day Consultation and Cystoscopy
When the urologist performs a cystoscopy (52000) (cystourethroscopy) for hematuria (599.7)... Read more
Get Paid for Unrelated Post Lithotripsy Pain
If a lithotripsy patient is admitted to the hospital during the global period for post-pro... Read more
Update:
Medicare Now Reimburses PSA Screening
Urology practices now can get reimbursed from Medicare for annual prostate cancer screenin... Read more
Reader Question:
Charging a Consult Visit
Question: One of our doctors stopped at another doctors office to see a patient. He is try... Read more
Reader Question:
Voiding Urethrocystographies
Question: Our practice usually does voiding urethrocystographies (VUCGs) in the hospital. ... Read more
Reader Question:
Catheter Insertion and Cystography
Question: When a radiologist performs a voiding urethrocystography (VUCG) or a cystography... Read more
Reader Question:
Stent Charge
Question: How do I code a bilateral ureteral stent change done through a cystourethroscopi... Read more
Reader Question:
Two Surgeons
Question: A patient presents with bilateral renal masses. The mass on the left was removed... Read more
Reader Question:
IVP and KUB Coding
Question: What codes should we use for IVP (intravenous pyleogram) and KUB (kidney ureter ... Read more
You Be the Coder:
Echography and Ultrasonic Guidance
Question: 76872 and 76942: Do we need to use modifier -25 to be paid for both of these o... Read more
Increase Payups and Cut Denials by Correctly Coding Post-op Follow Up
Contacting individual payers before submitting surgical package claims (50010-55865, exc... Read more
Get Paid for Tests and Test Supplies
Tying the test supplies purchased by practices to arguments for medical necessity and sp... Read more
Reader Question:
Discontinued Procedure
Question: How do you charge for a discontinued procedure (-53 modifier)? What would the fe... Read more
Reader Question:
Modifier -25
Question: I am having trouble getting a private carrier and an HMO to recognize modifier -... Read more
Reader Question:
Endoscopies
Question: Medicare has special rules for reimbursing multiple procedures when those proced... Read more
Reader Question:
Cystolithalopaxy, Bladder Tumors
Question: In order to know which CPT code to use for a cystolithalopaxy (52317 or 52318),... Read more
You Be the Coder:
Pessary Support Device
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Available Years:  2000  1999