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Urology Coding Alert

Case Study:
54324, 15740, 14040: Get the Scoop on the Best Way to Code Hypospadias Repair Procedures
Hint: Not all three codes are appropriate for most cases -- find out why. If you... Read more
Evaluation and Management:
Don't Let 3 EHR Pitfalls Compromise Your E/M Coding
These mistakes may cost your practice money and set you up for payer scrutiny.Many urology... Read more
Practice Management:
Time to Re-Enroll Your Urologist? You'll Have an Easier Job, CMS Says
You can fax or email the revalidation documents this time around.If your urologist sees Me... Read more
Reader Question:
Make the Primary vs. Assistant Surgeon Distinction
Question: I'd appreciate some help with how to bill for the following scenario for a patie... Read more
Reader Question:
Capture Cystogram Pay With 2 Codes
Question: What codes should I use for "on table cystogram" when the physician is looking f... Read more
Reader Question:
Stick With E/M for Nephrostomy Irrigation
Question: Is there a code for a nephrostomy tube irrigation done in the office?Oregon... Read more
Reader Question:
Method of Stone Removal Decides 52352 or 52320
Question: Our urologist performed an anesthetic cystoscopy with incision of a left uretero... Read more
You Be the Coder:
Is a 2-Days-Post-Op Return to OR Billable?
Question: We had a patient who was two days post op from a TURBNC (52500). The patient had... Read more
CCI 18.3:
Include I&D, Skin Suture Procedures With Your Urological Surgery Codes, Thanks to CCI 18.3
Review the record number of changes that hit CPT® codes on Oct. 1. Every quarter cod... Read more
ICD-10:
Differentiate Between Tenderness and Rebound Tenderness For ICD-10 Clarity
You'll still focus on type of pain and location to choose a code.When your urologist sees ... Read more
Modifiers:
Avoid Attaching Modifier 59 to the Wrong Code with These 2 Tips
Pointer: Correct your claims if you realize you have been doing it wrong.Now that you have... Read more
Accurately Identify a Separate Procedure
Medicare has clear guidelines for separate procedure.Having clear documentation of the pro... Read more
Global Periods:
Unlock Legitimate E/M Pay with These Global Period Keys
When your urologist makes the 'decision for surgery' matters.When your urologist performs ... Read more
Reader Question:
Never Use an Open Code for a Lap Procedure
Question: I was told by one of my physicians that I can use code 49491 for a laparoscopi... Read more
Reader Question:
Skip Wound Exploration with Lead Removal
Question: If the patient has an infection from an interstim lead and it is being removed a... Read more
Reader Question:
Sometimes Multiple Unlisted Codes are the Only Option
Question: My physician did the following:Laparoscopic ureterolysisLaparoscopic excision of... Read more
Reader Question:
Bilateral Stents Need Modifier 50
Question: My surgeon documented that he performed "cysto with bilateral ureteral stent pla... Read more
You Be the Coder:
Is 49585 Billable with 55866?
Question: When, if ever, can I separately report an umbilical hernia repair code (49585) d... Read more
CPT® 2013:
Rejoice! New Botox Bladder Injection Code Will Save You From Unlisted Code Challenges
Payment remains to be seen, but there's more hope in the new year.Since urologists began u... Read more
CPT® 2013:
64561 Descriptor Change Mimics Previous CCI Bundles
Key: Don't separately report 76000 or 77002.Not all of the coding changes for next year in... Read more
Quick Quiz:
Evaluate Your Own E/M Coding Skills With 3 Test Questions
Test your skills with these questions to see where you should focus your E/M education.Eva... Read more
CPT® 2013:
Pay Attention to E/M Verbiage Tweaks That Affect Your NPPs
Nearly every E/M code descriptor gets a facelift on January 1.Evaluation and management co... Read more
Quick Quiz Answers:
Evaluate Your Own E/M Coding Skills With 3 Test Answers
Check your coding against these answers to see where you should focus your E/M education.A... Read more
ICD-10:
Finally, You Can Plan Your ICD-10 Training With a Concrete Implementation Date
You'll have one additional year to prepare.CMS confirmed on Aug. 24 that ICD-10 will take ... Read more
Reader Question:
Beware of the 'Probable Diagnosis' Pitfall
Question: I've been told that if the treating physician orders a test based on a sign or s... Read more
Reader Question:
ICD-9 Freeze Will Spare You New Updates This Year
Question: Are there any ICD-9-CM updates planned for 2013?Iowa Subscriber Answer: No ICD-9... Read more
Reader Question:
Capture TURP and TRUS Pay With Modifier 59
Question: The urologist performed a TRUS and prostatic biopsy because of an elevated PSA, ... Read more
Reader Question:
Turn to Unlisted for Lap Vasectomy
Question: How should I report a laparoscopic vasectomy? I know there is no exact code, but... Read more
You Be the Coder:
Stone Removal Through Existing Nephrostomy
Question: My urologist indicated that he did a PCNL with antegrade nephrostogram and a Hol... Read more
Case Study:
Bladder Neck Procedures: Is 57288 Always the Best Choice?
Test your coding skills with this complicated operative report. Bladder neck surgeries... Read more
ICD-10:
Switch to K66.0 for Peritoneal Adhesion Diagnoses in 2014
You'll only need to note small exclusion note changes. While ICD-10 Codes will bri... Read more
Evaluation and Management:
Weave Your Way Through the MDM Calculation Path With 3 Tips
Pitfall: Don't miss the \"if this, then that\" notes when determining level of risk. When... Read more
News You Can Use:
Prepare for a 27 Percent Pay Cut Next Year If SGR Has Its Way
Some specialties will see steeper cuts and some will see pay raises -- find out wher... Read more
Clip and Save:
Tackle the MDM Counting Challenge With This Handy Worksheet
Add up the points to determine your level of MDM complexity. Figuring out how your urolog... Read more
Reader Question:
Capture KUB Work With 74000
Question: Is it appropriate to bill a KUB interpretation with an ESWL when the urologist ... Read more
Reader Question:
52310 vs. 52315 Depends on Stone Size
Question: One of my doctors did a cystoscopy with removal of stones from a prostatic chan... Read more
You Be the Coder:
Urinalysis With No Disease Process Diagnosis
Question: We have a patient who did not have a urinalysis done at his previous well visit... Read more
Antegrade Cystoscopies Through Established SP Tract
Question:How should I code the following procedure: Operative note reads: "The urethrot... Read more
CCI 18.2:
53860: Remodel Your Urethral Procedure Coding Thanks to CCI 18.2
Look to the modifier indicator to see if you can ever break the bundles. If your urolo... Read more
ICD-10:
Proposal Comments Show Split Opinions Abound on Pros and Cons of ICD-10 Delay
Plus, the AMA wants a further delay to 2015.Whether you submitted comments to CMS about th... Read more
News You Can Use:
Supreme Court Upholds ACA Legality -- What Does It Mean for Urology Practices?
Review the opinions of these top-in-the-field urology professionals on how ACA will affect... Read more
Reader Question:
Stick With 52353 x 1, Despite Multiple Stones
Question: My doctor did a cysto, ureteroscopy, holmium laser, and stone basket extraction ... Read more
Reader Question:
Turn to 51999 for Robotic Cystectomy Technique
Question: My urologist performed a robotic-assisted partial cystectomy. What code should I... Read more
Reader Question:
Don't Code 'Standing Order' Urinalysis Tests
Question: I just read the Urology Coding Alert article "81001-81003? The Order May ... Read more
Reader Question:
1 vs. 2 Codes for Penile Prosthesis Procedure Depends on Payer
Question: How would you code the removal of a three piece penile prosthesis and the reimpl... Read more
You Be the Coder:
Antegrade Cystoscopies Through Established SP Tract
Question: How should I code the following procedure:Operative note reads: "The urethrotome... Read more
Drug Administration:
Follow 3 Steps to Boost Your Injection and Infusion Code Know-How
Ensure truly separate E/M service before using modifier 25. With several codes to choose f... Read more
Radiology:
Check Your Diagnostic Imaging POS Assignments Carefully This Fall
You may find you need POS 22 more often than you did before.Nearly every urologist perform... Read more
ICD-10:
Focus on Bleed Location When Coding Hemorrhages Under ICD-10
998.11 expands to several codes, but you may only need four. When your urologist notes... Read more
Reader Question:
51990 May Capture Pay for Laparoscopic MMK Procedures
Question: My urologist is doing a robot assisted laparoscopic radical prostatectomy for pr... Read more
Reader Question:
Add 605 and 998.11 for Circumcision Repair
Question: My doctor repaired an incomplete circumcision with intermittent bleeding from ... Read more
Reader Question:
Consider 76872 for Prostate Gland Volume Study
Question: What is the correct billing for a volume study of the prostate gland? The urolog... Read more
Reader Question:
Include Vesiculectomies in 55866
Question: How should I code for the following: laparoscopic radical prostatectomy, cystosc... Read more
Reader Question:
Cystoscopy Coding Doesn't Vary Based on Access Method
Question: My urologist removed a patient's suprapubic (SP) tube and through the supr... Read more
You Be the Coder:
Balloon Dilation of Post-Op Bladder Neck Stricture
Question: How should I report the following procedure for a patient with a bladder neck co... Read more
Biofeedback Billing:
90901/90911: Take Control of Your Biofeedback Coding With 5 Expert Tips
Key: Pay attention to payer-specific rules. With only two codes to choose from when y... Read more
ICD-10:
CMS Proposes One-Year ICD-10 Delay
Don't miss: New date isn't yet set in stone. Practices have been wondering how... Read more
Correction:
Correction:
In the April 2012, Vol. 14, No. 4 issue of Urology Coding Alert the "You Be the Coder" ans... Read more
Documentation:
81001 or 81003? The Order May Clinch the Auditor's Decision
Plus: 2 tactics help keep tech troubles from derailing your coding.To be sure your documen... Read more
Code This!:
Complicated Ureteral-Ileal Anastomosis With Existing Loop
How would you report this procedure?Test your operative report interpretation skills with ... Read more
Billing Spotlight:
Do These Top 10 Errors Look Familiar? Find Out How to Easily Improve Your Claim Error Rate
Hint: Benefits verification can solve a lot of your denial problems.What's the top tool in... Read more
Reader Question:
99499 May Be Your Only No-Intervention Pay Option
Question: My urologist was called to the hospital to see a patient for a consultation. Aft... Read more
Reader Question:
Quackel Leads to 54430
Question: My urologist documented that he performed a "proximal cavernosal-spongiosum shun... Read more
You Be the Coder:
When Can You Add 38780?
Question: If my urologist does a radical nephrectomy with a retroperitoneal lymph node dis... Read more
CCI 18.1:
Q2043/96365 Bundle Bit the Dust on April 1
Nab your chance to resubmit claims for Provenge administration pay. Finalizing the officia... Read more
ICD-10:
Query Urologist for Urosepsis Clarification Before Coding
ICD-10 says urosepsis is "nonspecific" and thus, you won't find that termi... Read more
Provenge Therapy:
Q2043 Claims Won't Fly Unless You Meet Coverage Criteria
Combine research and billing system edits to boost accuracy.To stay on top of Medicare's c... Read more
Lab Tests:
81000-81003 Know-How Requires a Closer Look at Urinalysis Methods
Be sure you have the right code, whether you test for 1 element or all 10.Urinalysis may s... Read more
Code This!:
Stone Removal + Laser Treatment + Control of Bleeding
How would you report this procedure? Test your operative report interpretation skills ... Read more
Reader Question:
53860: Check With Payer Before Billing Renessa
Question: We are thinking of providing Renessa as a treatment option for stress urinary in... Read more
Reader Question:
No History? Don't Assume Comprehensive Level
Question: Our physician admitted someone as an initial inpatient, but couldn't get all her... Read more
Reader Question:
Look to Unlisted J Code for Trimix
Question: How should we bill for Trimix when used for erectile dysfunction?Texas Subscribe... Read more
Reader Question:
Support Sebacious Cyst Removal With 2 Diagnosis Codes
Question: Is a cyst the same as abscess so far as for picking a procedure code? I know med... Read more
You Be the Coder:
Report Coaptite® Injections Regardless of Gender
Question: We have a male patient that our doctor would like to inject with Coaptite®... Read more
Botox Breakdown:
Perk Up Your Botox Claims With 4 Expert Tips
Hint: Be sure to check your payer's approved diagnoses. Many urologists are using... Read more
ICD-10:
ICD-10 Implementation Won't Be As Close As First Thought
HHS confirms a delay in the implementation plan is coming. If you have been worrying a... Read more
News You Can Use:
You Can Stop Worrying About a 27 Percent Medicare Cut -- Until the End of the Year At Least
10-month delay will only push payment formula problems to 2013.If your practice has been o... Read more
Code This!:
Scope Out the Proper Coding for this Surgery
How would you report this procedure?Test your operative report interpretation skills with ... Read more
Correction:
Correction:
There was a code error in the February 2012 issue of Urology Coding Alert in the "You Be t... Read more
Reader Question:
Don't Stress Over NMP-22 Pay Decrease
Question: In the article "Think You Have a Handle on the 2012 Code Changes? Find Out Fast"... Read more
Reader Question:
Code Polymark Markers As You Would Other Markers
Question: How should I code for polymark marker placement?Washington SubscriberAnswer: You... Read more
Reader Question:
51728 Requires Patient Voiding
Question: I am having discussions with our doctors and nurses who perform urodynamics stud... Read more
Reader Question:
Stick With J3301 for Kenalog, Regardless of Manufacturer
Question: My doctor is using Kenalog 40 (NDC 0003029328) from Bristol Meyers Squibb. He sa... Read more
Reader Question:
Skip 57160 Without Fitting
Question: We are a urology office, and the doctor had a patient the other day with a vagi... Read more
Reader Question:
Avoid Provider Type 38 for Initial NF Visit Billing
Question: I am receiving denial C0-170 (Payment is denied when preformed/billed by this ty... Read more
You Be the Coder:
When Does the Urologist Count as a Co-surgeon?
Question: A patient had an open sigmoid resection. The general surgeons did the resection.... Read more
Coding for Technology:
52647-52649: Obliterate Laser Prostate Treatment Coding Troubles With This Expert Guidance
Just because the operative notes mention 'laser' don't assume 52647-52649. ... Read more
ICD-10:
Combine Kidney Plus Ureter Calculus Under 1 Code in 2013
Use 2 examples to master Excludes1 vs. Excludes2 notes.Kidney stone sufferers number in th... Read more
Quick Quiz:
Think You Have a Handle on the 2012 Code Changes? Find Out Fast
Test your ICD-9, CPT®, and HCPCS 2012 knowledge before the denials start rolling in.... Read more
Quick Quiz Answers:
Think You Have a Handle on the 2012 Code Changes? Find Out Fast
Check your 2012 coding update savvy. Find out if you're set to properly code your ... Read more
News You Can Use:
Don't Expect CMS to Update 'New Patient' Determination Based on Subspecialty
In other news: You can still avoid additional e-scribe penalties. As many veteran code... Read more
Code This!:
Decipher Complicated Transrectal Biopsy Case Coding
How would you report this procedure?Test your operative report interpretation skills with ... Read more
Reader Question:
50 vs. RT/LT for Bilateral Nephrostomy Replacement Depends on Payer
Question: A patient had bilateral nephrostomy tubes replaced. We were going to report CP... Read more
Reader Question:
Look to 17110 For Cauterization
Question: What is the code for cauterizing an ulcer on the perineum? It was done to reli... Read more
Reader Question:
No Injection Means No Pay
Question: I do the coding and billing for a urologist who is under the impression that whe... Read more
Reader Question:
52260 Doesn't Require IC Diagnosis
Question: Can you offer some help regarding the use of CPT 52260 even when the pathology ... Read more
You Be the Coder:
Surgical Removal of Lower Ureteral Segment and Partial Cystectomy
Question: The doctor performed a left distal ureterectomy, partial cystectomy, ureteral re... Read more
CCI 18.0:
Skip Catheterization Coding With Still More Procedures, According to CCI
Plus, you'll find 51597 bundles several procedures now as well. Every year at this... Read more
ICD-10:
Prostate Cancer Coding Mirrors ICD-9 Neoplasm Table Structure
Hint: You'll apply the same PIN rules even when the codes change.If you don't have any tro... Read more
CCI 2012 Update:
Learning the Latest CCI Bundles Isn't Enough -- Get to Know the Overarching Manual Changes, Too
CMS offers clear guidance on what to include in pelvic exenteration coding. Although c... Read more
News You Can Use:
You'll Be Spared a 27 Percent Pay Cut -- At Least Until the End of February
At nearly the last minute, Congress votes to boost conversion factor.Although the governme... Read more
News You Can Use:
Figure Out Which 5010 Category Your Practice Falls Under
Watch out: Not everyone will have until March 31 to comply.You thought you wouldn't face e... Read more
Reader Question:
Laparoscopic Retroperitoneal Lymph Node Dissection Requires 38589
Question:Which is the correct code for a laparoscopic retroperitoneal lymph node dissectio... Read more
Reader Question:
53502: Confirm Gender Before Coding
Question:We have a patient that previously had a creation of a Mitrofanoff and closure of ... Read more
Reader Question:
Choose 50544 For a Robotic UPJ Obstruction Repair
Question:How would I code a robotic ureteropelvic junction repair?Florida SubscriberAnswer... Read more
Reader Question:
Save Time-Based E/M for Counseling/Coordination Heavy Visits
Question:If the physician documents: "Time spent in the evaluation of the patient with mos... Read more
Reader Question:
Report Two Codes for Combined, Not Converted Procedure
Question:My urologist does what he calls a robotic assisted nephroureterectomy. He re... Read more
Reader Question:
Bladder Neck Incision, BNI, Coding Depends on Cause
Question:What code should I use when my doctor writes only "TUIBNC"?Wisconsin SubscriberAn... Read more
Reader Question:
50820 For Ileal Neobladder or Just Ileal Conduit?
Question:What is the difference between a neobladder and ileal conduit?For an ileal condui... Read more
Reader Question:
Capture EpiPen® Kit Pay With J0171
Question:We used the EpiPen® kit in the office for a patient who experienced an alle... Read more
You Be the Coder:
Reposition Your Return to OR Coding With Modifiers
Question:A patient had an artificial urinary sphincter inserted and later on that night, l... Read more
Case Study:
50230 vs. 50546: This Nephrectomy Coding Challenge Points You in the Right Direction
Key: Your secondary diagnosis will help get your claim paid. Any number of reasons can cau... Read more
ICD-10:
Plan For Six Renal Tumor Diagnosis Codes in 2013
Right and left will matter under ICD-10.When your urologist diagnoses that a patient has a... Read more
CPT® 2012:
Start -- Or Rather, Keep -- Applying New Preventive Services Modifier 33
Watch for payer specific rules for using the modifier. You may be cheering the addition of... Read more
ABN Advice:
Incorporate New ABN To Collect For Non-Covered Services Going Forward
Even though there aren't substantial changes on the form, you need to make the switch.Now ... Read more
Reader Question:
Say Goodbye to Inappropriate Payments for Urodynamic Studies
Question: I am with the billing office for a urologist and am having an issue with reimb... Read more
Reader Question:
Retire 86294 For NMP-22 Bladder Test Checks
Question: We perform bladder test checks in the office fairly often. Recently we have been... Read more
Reader Question:
Hospital Ownership/Operation Determines Medicare's '3-Day Payment Window' Effect
Question: I keep hearing about some "three-day payment window" that will affect Medicare p... Read more
Reader Question:
New vs. Established: CPT® 2012 Clarifies Subspecialty Coding
Question: I heard there will be changes in 2012 to when we should report a new patient cod... Read more
Reader Question:
Review Retrograde Urethrogram Coding Requirements
Question: I have run into some notes that state that the physician performed a retrograde ... Read more
You Be the Coder:
53899: New Prostate Ablation Technique Requires Unlisted
Question: My doctor performed ablation of the prostate using irreversible electroporatio... Read more
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