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Urology Coding Alert

HCPCS 2012:
Q2043: New HCPCS Code Will Bring You $32,000 x 3 -- If You Bill It Properly
Include proper primary and secondary diagnosis codes to ensure payment. If your urolo... Read more
ICD-10:
Urogynecology Repairs Won't Require Too Much Diagnosis Conversion Work
Enterocele, rectocele, urethrocele, and cystocele codes will have 1-1 crosswalks.If your u... Read more
CPT® 2012:
Avoid 57283 With Other Procedures Involving Enterocele Repair, CPT® Warns
You can rejoice that there will be only a few CPT Codes 2012 changes affecting your urol... Read more
CPT® 2012:
Easier Initial Observation Coding Will Come Your Way in January
New typical time assignments will mirror subsequent observation codes. When CPT Codes ... Read more
CPT® 2012:
Look Forward to 'Other Qualified Healthcare Professional' Clarification
Watch out: The new definition isn't all good news.If you've wondered what "other qualified... Read more
Fee Schedule News:
Start Hoping for Congress to Step In, Or You'll Face a 27 Percent Pay Cut
The wait-and-worry game starts now.Get ready for another year of nail-biting to find out w... Read more
Reader Question:
041.4 Requires a Fifth Digit Now
Question: Has there been a change to 041.4? We keep getting denials and I can't figure out... Read more
Reader Question:
Never Report Incorrect Codes Just to Ensure Payment
Question: I work in the office for a urologist who also performs laparoscopic procedures. ... Read more
Reader Question:
Need More Than 1 PQRS Code? Go Ahead
Question: Can we report more than one PQRS code measure on the same claim?Iowa Subscr... Read more
You Be the Coder:
Switch From 40818 to 20926 or 15240 For Buccal Graft Excision
Question: My urologist performed a urethroplasty along with a buccal graft. How should I r... Read more
CCI 17.3:
44970: Leave Out Lap Appendectomy When Coding Most Urological Procedures, CCI Warns
If you don't know the meaning of '0' modifier indicators, you're asking ... Read more
ICD-10:
Move From 1 Dysuria Code to 2 in 2013
Don't be tempted to use F45.8.When your urologist sees a patient with pain during urinatio... Read more
Quick Quiz:
Test Your Bladder Tumor Removal Know-How With 5 Questions
Hint: Pay attention to the payer you're coding for. Coding transurethral bladder t... Read more
Medicare Compliance:
Pay Attention to E/M Levels, G Modifiers, and More, OIG Warns
Check your compliance on the areas in the 2012 Work Plan before OIG does.Every practice kn... Read more
Quick Quiz Answers:
Test Your Bladder Tumor Removal Know-How With 5 Answers
Check your complicated case savvy against the advice from the experts. Find out if you... Read more
Reader Question:
52000 + E/M Depends on Planning
Question: If my urologist has a patient return to the clinic for an annual cystoscopic exa... Read more
Reader Question:
Modifier 59: Ensure Separate Site of Service Before Appending
Question: I have an insurance company that is not paying for a code, stating it is bundled... Read more
You Be the Coder:
Does Laser Change Urethral Stricture Coding?
Question: One of my doctors performed a laser incision of a urethral stricture and also a ... Read more
Prostate Procedures:
52601 and 52630: Avoid TURP Denials By Learning the Nuances of These 2 Codes
Hint: There is an exception to the 'once in a lifetime' procedure mantra. If ... Read more
Clip and Save:
Capture TURP Procedures Properly With This Handy Coding Flowchart
Just follow the path to discover the code you should be using for every TURP your urologis... Read more
Modifier Mythbuster:
Bust 5 Common Modifier 24 Myths to Ensure Deserved Reimbursement
Hint: Focus on the documentation, not the diagnosis codes.To ensure payment for E/M servic... Read more
ICD-10:
Get Inguinal Hernia Laterality Details Before Choosing ICD-10 Code
You'll still need obstruction, recurrence data as well.If your urologist teams up with gen... Read more
Reader Question:
Skip Penile Block With Verpamil Injection Coding
Question: How do I code a Verpamil injection and the associated penile block?Ohio Subscrib... Read more
Reader Question:
52330 vs. 52332 Depends on Manipulation
Question: Our doctor did a cystoscopy and had to manipulate the guidewire past a ureteral ... Read more
Reader Question:
078.11 Covers Condyloma Acuminata Lesions
Question: Our doctor did an excision and fulguration of meatal condyloma. The lesion was 2... Read more
Reader Question:
Choose Between J3300 and J3301 for Kenalog Injections
Question: How should I report an intra-epidiymal injection of Kenalog?South Carolina Subsc... Read more
Reader Question:
Don't Forget 50 for Bilateral JJ Stents
Question: The doctor's slip states: "cysto, bilateral ureteroscopy, bilateral stents, biop... Read more
Reader Question:
Uncomplicate Complicated Observation, Admit, Discharge Combo Billing
Question: I have trouble figuring out how to charge for a patient that was in observatio... Read more
You Be the Coder:
Strike Gold With In-Office Seed Placement Coding
Question: How should I report gold seed marker placement performed in the office when the ... Read more
Uroflowmetry:
51736, 51741: Skip Some Modifiers, Thanks to Change in Global Period Designation
Pitfall: Watch out for payer-specific rules, however.Multiple codes, code additions and de... Read more
ICD-10:
Prepare to Get More Specific With Azoospermia Diagnoses in 2013
Make sure your urologist is starting to put the details in his documentation now. When... Read more
Incident-to Billing:
3 Guidelines Help You Master NPP Billing and Ensure 100 Percent Reimbursement
Don't forget you can still get 85 percent reimbursement if you don't meet incident-to crit... Read more
Clip and Save:
Ease the Incident-To Decision Making With This Handy Chart
Follow the path to figure out if you can bill a Medicare service incident to the physician... Read more
Reader Question:
189.3 vs. 223.81 Depends on Pathology
Question: What ICD-9 Code should I use when the doctor documents "tumor of the urot... Read more
Reader Question:
Choose J3430 For Vitamin K
Question: My physician gave a patient a 10 mg injection of vitamin K. How should I report ... Read more
Reader Question:
Query Physician For Diagnostic Details
Question: My urologist performed a left testicular prosthesis placement and the operative ... Read more
Reader Question:
Catch Up to ICD-10 Timeline
Question: We just learned about ICD-9 Codes 2012 changes that go into effect Oct. 1, 201... Read more
Reader Question:
Assign 3 'Vitals' to Just 1 Exam Bullet
Question: Would you please explain how taking the vital signs contributes to determining t... Read more
Reader Question:
Add 52 If The Physician Skips Cystourethroscopy
Question: My doctor did a looposcopy with lithotripsy and stone removal. What is the pro... Read more
Reader Question:
50548 + 50650 Warrants Modifier 59
Question: How should I code for a hand-assisted laparoscopic total nephroureterectomy with... Read more
Reader Question:
76942 Or 76998 Depends on Place of Service
Question: Would there be an appropriate ultrasound code when the physician does an ultra... Read more
You Be the Coder:
Differentiate General Surgeon's and Urologist's Work
Question: How should I report the following surgery? 16-year-old boy with spina bifida wit... Read more
ICD-9 2012 Update:
Get Specific With New ICD-9 Cystostomy and Mesh Complication Codes in October
You'll be able to stop using unspecified fifth digits. While the next edition of I... Read more
ICD-10:
ICD-10 Brings Even More Cystostomy Complication Specificity
Tip: Get your urologist documenting details about the complications now. In the articl... Read more
CCI 17.2:
CCI Bundles Urethral Catheterization With Even More Procedures
Plus, if your doctor performs urogynecology procedures you'll have new edits to take... Read more
Clip and Save:
Easily Remember What Equals a Signature With This Handy Tool
Tip: Avoid using a signature stamp.Learning the ins and outs of what constitutes a complia... Read more
Correction
There was a code error in the last issue of Urology Coding Alert in the article "Perfect Y... Read more
Reader Question:
52354: Attach Modifier 50 For Different Lesions
Question: My doctor documented the following procedure "cysto, bilateral ureteroscopy, bil... Read more
Reader Question:
53899: Is this CPT® Code Your Lap Renal Pelvic Stone Removal Choice?
Question: One of my doctors did a robot assisted laparoscopic pyeloplasty (CPT 50544 ) and... Read more
Reader Question:
Apply Modifier 52 For One-Sided Lymphadenectomy
Question: My doctor did an open retropubic radical prostatectomy. In this case he only rem... Read more
Reader Question:
54115: Ensure Deep Tissue FBR Before Coding
Question: Would removal of a penile-scrotal ring that was not inside the penis be billed a... Read more
Reader Question:
Who if Financially Responsible for a Stent Purchase?
Question: We have a patient that needs a special ureteral stent, and we had to order it ou... 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 get the... Read more
Reader Question:
54840 + 55040 Depends On Difficulty/Time
Question: My urologist is performing a hydrocelectomy (CPT 55040) . If he also excised a s... Read more
You Be the Coder:
Bladder, Ureter Repair After Surgical Damage
Question: How should I report the following operative report:Procedure:Exploratory laparot... Read more
CPT® 2011 Update:
64566: Perfect Your PTNS Coding and Reimbursement With This New Code
Stop separately reporting programming or you'll face denials.Historically, getting paid fo... Read more
Possible ICD-9 Codes to Support PTNS
ICD-9 788.31 -- Urge incontinenceICD-9 788.33 -- Mixed incontinence (male) (female)ICD-9 7... Read more
ICD-10:
Don't Stress About Incontinence Diagnosis Changes in 2013
Keep this list handy so you know the new codes you'll be using. When your urologis... Read more
Evaluation and Management:
4 FAQs Ease the Stress of Choosing Physical Examination Levels 4 FAQs Ease the Stress of Choosing Physical Examination Levels
1995 vs. 1997 guidelines: Choose one per claim, but feel free to use either one for differ... Read more
Clip and Save:
Quickly Determine Which Exam Level Your Urologist Has Documented With This Handy Chart
Be sure you choose the guidelines that will be most advantageous to your coding.With two s... Read more
Reader Question:
Coding for a Penile Fracture
Question: My urologist saw a patient who had a fracture of penis. He made an incision arou... Read more
Reader Question:
Bill Both Excision and Closure for In-Office Lesion Removal
Question: My physician excised scrotal cyst that was 6 cm in the office with an intermed... Read more
Reader Question:
55899: Remember to Benchmark to Existing Codes When Using Unlisted CPT® Codes
Question: The doctor did a laparoscopic robotic assisted suprapubic prostatectomy for BPH ... Read more
Reader Question:
52332-50 Tells the Bilateral Stent Insertion Tale
Question: A patient was taken to the operating room and had a bilateral stent insertion be... Read more
Reader Question:
52354 Encompasses Cysto, Biopsy, and Ablation
Question: My urologist saw a Medicare patient and documented the following operative pro... Read more
You Be the Coder:
When Can You Separately Report Ureteral Dilation?
Question: My doctor performed a cystoscopy, dilatation of the ureter, right retrograde pye... Read more
Pediatric Urology:
50845, 51960: Learn the Keys to Properly Coding MACE, Mitrofanoff, and More
You'll be able to report anastomosis with some procedures and not others.If your urologist... Read more
ICD-10:
596.54 Will Translate to ICD-10 Easily
The one-to-one code matchup makes updating your superbill a snap. When your urologist ... Read more
Case Study:
Modifier 78 Is Your Ticket to Complication Corrections During the Postoperative Period
Watch out for CCI bundling as well -- you may need a second modifier.When your urolog... Read more
Documentation:
Ensure Your Urologists' Signatures Pass Muster By Answering These 2 Key Questions
Hint: Beware of EMR signature pitfalls.Including provider signatures is a basic documentat... Read more
Reader Question:
52204 Captures Prostatic Urethra Biopsy
Question: A patient underwent a transurethral incision of the prostate with a transurethra... Read more
Reader Question:
54640 vs. 54600: Look At Orchiopexy Purpose
Question: I know that an orchiopexy is for an undescended testicle; however, I have also... Read more
Reader Question:
Save Hip Dx For Other Surgeons
Question: If the urologist is called to the OR to intra-operatively place a Foley catheter... Read more
Reader Question:
45560 or 57250 Depends on Procedure Specifics
Question: I have a physician who performed a colpocleisis and then a TVT sling. He then st... Read more
Reader Question:
51999 Is Your Only Da Vinci Excision Choice
Question: Could you offer a suggestion for da Vinci robotic excision of a urachal cyst? ... Read more
You Be the Coder:
50236 or Unlisted For Lap Nephroureterectomy With Lymph Node Dissection?
Question: Our physicians did a laparoscopic nephroureterectomy with an open intravesical... Read more
CCI 17.1:
51565: Don't Double Dip When Reporting Partial Cystectomy Procedures
Watch out for 'standards of surgical practice' edits surrounding 55706.If your urologist p... Read more
ICD-10:
591: Expand Your Hydronephrosis Coding in 2013
Check the urologist's documentation for mention of infection to start down the right code ... Read more
Evaluation and Management:
99204-99205, 99214-99215: Stop Forfeiting Level Four and Five E/Ms With 3 PMFSH Tips
Make your urologist's job easier by letting the patient or nurse document the history.If y... Read more
Aspects of PFSH
Per CPT®, past medical, family and/or social history is divided into three subsectio... Read more
Clip and Save:
Easily Capture PMFSH Data With This Handy Worksheet
Hint: You can have the patients document their own history as long as the urologist review... Read more
Reader Questions:
51700 Requires More Than Placement Check
Question:What codes should I use when my urologist performed bedside irrigation of an alre... Read more
Reader Questions:
Add 51700 For Documented Barbotage
Question:Can I code for bladder barbotage the urologist does while the patient is also hav... Read more
Reader Questions:
Consider V58.42 For Post-Op Disease Counseling
Question:We had a patient with a prostate cancer diagnosis who had an office visit during ... Read more
Reader Questions:
Base 99291-99292 on Care, Not Location
Question:After a patient with chest pain "coded" in the ER and was admitted to the ICU, ou... Read more
Reader Questions:
52001-59: When Can You Break the Bundle?
Question:In the evaluation of gross hematuria the urologist first evacuated multiple obstr... Read more
Reader Questions:
Does 49203-49205 Apply For Liver Mass Excision?
Question:What code would I use for an excision of a retro hepatic mass via thoracic-abdomi... Read more
You Be the Coder:
50605: To Add or Not to Add to Pyeloplasty Coding?
Question: How should I report "dismembered pyeloplasty with right nephrostomy and... Read more
Prostate Procedures:
G0103 vs. 84153: Follow 3 Guidelines for Foolproof PSA Test Coding
The diagnosis code you choose will make or break your claim. When your urologist perfo... Read more
News You Can Use:
Scrap 96402 For Lupron Injections in Noridian Patients
Apply the new rule to claims after March 1.If your practice sees patients with insurance c... Read more
Modifier Mythbuster:
Bust 3 Myths to Avoid the Catch-22 of 'Increased Procedural Services'
If you assume you can always append modifier 22 in certain clinical situations, you're hea... Read more
ICD-10:
Trade V Code for Z Code on PSA Screenings
You'll find a one-to-one relationship for both screening and diagnostic PSA diagnose... Read more
Reader Questions:
J2001 Reimbursement Depends on Administration Type
Question: The Correct Coding Initiative ( CCI Edits ) tells me if I bill J2001 with eith... Read more
Reader Questions:
Decipher Column 1, Column 2 CCI Codes
Question: Sometimes I cannot find the two codes I intend to bill in the CCI Edits . How d... Read more
Reader Questions:
Select 53899 for Cannulation
Question: I'm unsure how to code for cannulation of colovesical fistula. The doctor also d... Read more
Reader Questions:
No Void Leaves a Void in Your Urodynamics Coding
Question: If a patient cannot urinate at the end of the biofeedback, can we charge CPT 517... Read more
Reader Questions:
Assign 99221 Plus Office Visit Based on Dates and Physician Presence
Question: Our urologist saw a patient in the office, then admitted her to the hospital lat... Read more
Reader Questions:
Reserve 185 for Malignancy
Question: One of my providers did a TURP on a patient and sent everything to pathology. Wh... Read more
You Be the Coder:
Does Trigone Cauterization Warrant 52214-59?
Question: A patient underwent hydrodistention under general anesthesia for treatment of ... Read more
Endourology:
52332: Keep Reimbursement Flowing By Getting a Grasp on 2 Common Stent Coding Pitfalls
Beware: All 'stents' are not created equal. When your urologist places a stent... Read more
ICD-10:
Get Specific With Ureteral Stone Diagnoses in 2013
Here's what you should look for in your physician's documentation. When ICD-9 ... Read more
News You Can Use:
Take the 'Initiative' to Get Started With PQRS
By 2015 you'll face penalties for not reporting quality measures.If your practice is not a... Read more
Clip and Save:
Cover Every System Possible With This Handy Beyond-Genitourinary ROS Tool
Ensuring your urologist's documentation captures every system he reviewed will help ... Read more
Reader Questions:
S2900 + 55866 Is a No-No For 2011
Question: I reported S2900 to a private payer for a robotic-assisted laparoscopic prostate... Read more
Reader Questions:
58 vs. 78 Depends on Planning
Question: In October, a patient had extracorporeal shock wave lithotripsy, which carries a... Read more
Reader Questions:
55530 Won't Depend on Number of Veins
Question: In reference to the varicocelecomy (CPT 55530 ) which is an excision of varicoce... Read more
Reader Questions:
99304-99306 Require 3 Key Components
Question: How do I code if our physician went to the nursing home to see Medicare patients... Read more
Reader Questions:
86294 Requires QW Modifier
Question: Can we expect reimbursement for CPT 86294 ?Answer: Use 86294 (Immunoassay for tu... Read more
Reader Questions:
Modifier SA May Mean NP Pay Reduction
Question: When the NP provides unsupervised services, I bill the codes under the nurse pra... Read more
You Be the Coder:
Renal Mass Biopsy and Ablation
Question: My doctor did a cystoscopy, ureteroscopy, biopsy of renal pelvic mass, holmium l... Read more
CCI 17.0:
Check CCI Before Going to Town With New 2011 Codes 49237, 53860, 64566, and More
Start capturing additional pay by separating wound care management codes 97597-97602 from ... Read more
Evaluation and Management:
Stop Letting ROS Conundrums Thwart Your Level 4 and 5 E/M Coding
Ensure you have documentation of each system -- or prepare to assign a lower code.Lev... Read more
News You Can Use:
Rejoice in a 1-Year Medicare Pay Fix
If you aren't e-prescribing in 2011, you'll face pay cuts next year, CMS says.You won't fa... Read more
Reader Questions:
Choose 90911 For Biofeedback, Not PFMR
Question: Our urologist started performing pelvic floor muscle training in the office, and... Read more
Reader Questions:
Apply 52234 for Urethral Tumors, Too
Question: How should I report a TUR of a 1.5 cm urethral tumor?Answer: Since the terms ure... Read more
Reader Questions:
52281 and 52204? Depends on the Payer
Question: One year following a radical prostatectomy for prostatic carcinoma, the patient ... Read more
Reader Questions:
50590 Cancels Ureteroscopy Coding For Same Stone
Question: If a patient undergoes a right ureteroscopy with an incomplete laser fragmentati... Read more
Reader Questions:
52214 Isn't Gender Specific
Question: I have a female patient that had fulguration of the bladder and trigone. The des... Read more
Reader Questions:
55250 Includes Post-Vasectomy Semen Analyses
Question: I am currently billing the post-vasectomy semen analysis. How many post operativ... Read more
Reader Questions:
52214 vs. 52234 Depends on Resection
Question: During laparoscopic nephroureterectomy for renal pelvic tumor we start the case ... Read more
You Be the Coder:
52300 or No 52300? That Is the Ureterocele Question
Question: My urologist performed a cystoscopy, transurethral incision of an orthotopic ure... Read more
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