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Urology Coding Alert
Urology Coding Alert
Urology Coding Alert - 2015; Volume 17, Number 12
Case Study:
Properly Deciphering Operative Reports Is Key to Correct Payment
Don’t forget to add the proper modifiers. Your urologist’s operative repor...
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ICD-10:
Payers and Practices Alike Are Reporting Successful Transitions
You may see a small delay in payments. If you’re like most other coders, you wer...
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Incident-To Billing:
Understand 'New Problem' Terminology To Accurately Bill Incident-to Services
Check state laws, too. Your urology practice can increase the number of patients you c...
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Reader Question:
Focus Your Laparoscopic Ureteral Reimplantation Coding
Question: We performed a robotic assisted laparoscopic distal left ureterectomy, ps...
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Reader Question:
Find PFSH To Decide Overall History
Question: I have a urologist’s note for an office visit that clearly indicate...
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Reader Question:
Avoid OIG Scrutiny of POS Codes
Question: I have heard that MACs are paying close attention to our place of service...
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You Be the Coder:
Location Matters for Complication Treatment Billing
Question: If a patient has a TURP (52601) and 14 days later has urinary retention, ...
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Urology Coding Alert - 2015; Volume 17, Number 11
ICD-10:
Revisit 5 Key Pointers To Ensure You are Set for ICD-10 Success
Remember, family matters to CMS. With the Oct. 1, 2015 ICD-10 implementation date behi...
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ICD-10:
Move Beyond Implementation, But Don't Stop Training
Continue to stress coder/provider cooperation for success. While you can breathe a si...
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ICD-10:
Recognize the Positive Impacts ICD-10 Brings to Your Practice
Hard copy resources may make your job easier. Even though Oct. 1 has passed, your prac...
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Reader Question:
Indicate 'Path Pending' With D49.5
Question: What ICD-10 code would I use to indicate the pathology is still pending f...
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Reader Question:
CMS's Billing Software Won't Eliminate ICD-10 Conversion
Question: I have heard that Medicare has created free billing software that will le...
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Reader Question:
Don't Use ICD-9 and ICD-10 on 1 Submitted Claim
Question: Our urologist admitted a patient in September and didn’t discharge ...
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Reader Question:
Save 'Unspecified' Codes For Insufficient Documentation
Question: If I find that a common ICD-9 code that I use doesn’t have a direct...
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Reader Question:
Check With Your WC Payers Before Using ICD-10
Question: I have heard I won’t use ICD-10 for workers’ compensation rel...
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Reader Question:
Get to Know Diabetes ICD-10 Codes
Question: Our practice sees patients with both type I and type II diabetes, but it ...
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You Be the Coder:
Stent Removal Diagnosis
Question: What ICD-10 code should I report for the urologist’s work removing ...
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Urology Coding Alert - 2015; Volume 17, Number 10
CPT® 2016:
Update Your Percutaneous Nephrostolithotomy Coding For the New Year
Stop reporting radiology codes with renal catheter insertions. Labor Day marks the un...
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CPT® 2016:
Learn 2 New Penile Trauma Codes
Plus, you’ll have three new urology-related add-on codes in 2016. The 2016 chan...
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CPT® 2016:
Pinpoint 2 New E/M Codes You May Use
Stay tuned for reimbursement answers. While there are not many evaluation and managem...
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Reimbursement News:
Watch for Potential 2016 Fee Changes That Could Reduce Your Reimbursement
Reversal of some schedule changes could be good for your practice. Code updates aren&...
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ICD-10:
Get Answers to Top ICD-10 Grace Period Questions
Private payers may not offer the same leeway. With October 1 just around the corner, y...
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You Be the Coder:
Looposcopy of Ileal Loop With FB Removal
Question: Can you please help me code the following operative report? POSTOPERATI...
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Urology Coding Alert - 2015; Volume 17, Number 9
Procedure Primer:
Tackle TURP Coding With 3 Expert Tips
Forget the ‘once in a lifetime’ mantra. While transurethral resection of t...
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ICD-10 Quiz Answers:
Test Drive Your ICD-10 Coding Skills With 10 Answers
Find out your weak points now to solve problems before denials roll in. The October I...
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Don't Make This Crucial Observation Coding Mistake
Timing is everything when choosing a code. When your urologist admits a patient to obs...
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Reader Questions:
Capture Payment for Same-Day Urinalysis, E/M
Question: What is the appropriate modifier to use with 81003 for an automated test ...
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Reader Questions:
Don't Stop ICD-10 Prep Based on CMS News
Question: I heard that CMS issued a statement saying we’ll have a one-year re...
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Reader Questions:
Use 2 Codes for FNA with Imaging Guidance
Question: My urologist documented that he performed a “transrectal seminal ve...
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Reader Questions:
Count the Prosthesis Parts for Coding
Question: What code should I report for a two-piece penile implant? I use 54400 for...
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You Be the Coder:
Properly Benchmark Robotic-Assisted Lap Prostatectomy
Question: What is the proper way to code a robotic-assist laparoscopic simple prost...
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Urology Coding Alert - 2015; Volume 17, Number 8
Case Study:
Shore Up Your Complicated Nephrostomy Tube Removal Coding
Tip: Details matter to ensure proper code selection. Percutaneous nephrostomy is...
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ICD-10 Quiz:
Test Drive Your ICD-10 Coding Skills With 10 Questions
Find out your weak points now to solve problems before denials roll in. Before l...
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Evaluation & Management:
Clear Up MDM vs. Medical Necessity Confusion or Face Denials
Make sure your urologist knows what he is signing when submitting claims. Justifying h...
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Reader Questions:
Suture Placement Decides MMK or Burch
Question: I saw your article “Follow This Roadmap to Capture Correct MMK Pay&...
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Reader Questions:
Open Placement Changes S/P Tube Coding
Question: How should I report a cystoscopy and SP tube placement? South Dakota Su...
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Reader Questions:
Query Urologist for Full Procedure Details
Question: My urologist is going to be performing surgery for an adult patient whose...
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Reader Questions:
Consider a Granuloma a Lesion
Question: A patient has a sperm granuloma on the end of his spermatic cord (stump) ...
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Reader Questions:
Stricture Location Determines Dx Code
Question: What is the best diagnosis code for a left uretero-intestinal anastomotic...
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Reader Questions:
Capture Return-to-OR Pay with 78
Question: A patient had a ureteral reimplant early in the afternoon. Later that eve...
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Reader Questions:
CCI Modifier Indicator Has the Final Say
Question: I billed Medicare for 52353,-LT and 52351-RT-59. Medicare denied 52351, s...
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Reader Questions:
Post Updated NPPs
Question: Our office is updating our Notice of Privacy Practices (NPP) to include t...
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You Be the Coder:
Total Nephroureterectomy Using 3 Separate Surgical Approaches
Question: Our urologist did a cystoscopy and using a Collins knife incised the intr...
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Urology Coding Alert - 2015; Volume 17, Number 7
Urogynecology Case Study:
Follow this Roadmap to Capture Correct MMK Pay
Modifier missteps could cost you nearly $800. If your urologist documented that he per...
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Modifiers:
Capture 62.5 Percent With These 3 Modifier 62 Tips
Check the fee schedule to see if you can even use 62 on a code. When your urologist wo...
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ICD-10:
Update Your MMK-Related Diagnoses This Fall
You’ll have an easy transition with these codes. During the Marshall-Marchetti-K...
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Evaluation & Management:
Prepare for E/M Self-Audits By Gathering All the Facts
Review your payer’s comparative billing reports to see where your practice fits. ...
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Reader Questions:
Look Beyond CCI Edits
Question: My physician performed an excision of an infected urachal cyst, and then ...
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Reader Questions:
Pinpoint Decision for Surgery DOS
Question: A patient had an office visit (99213) with a 185 diagnosis on Feb. 17. T...
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Reader Questions:
Define Whitmore Cocktail to Find the Code
Question: What code should I report when the urologist administers a “Whitmo...
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Reader Questions:
Cystoscopy Matters for 50947
Question: Does code 50948 require cystoscopy with stent placement? If the urolog...
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Reader Questions:
Consult Urologist on Lesion Type
Question: Which code should I report when my urologist documents that he removed a ...
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You Be the Coder:
Next-Day Nephrectomy Completion
Question: The surgeon did a partial nephrectomy, and the day after, it was discover...
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Urology Coding Alert - 2015; Volume 17, Number 6
Pediatric Urology:
Repair Your Hypospadias Procedure Coding With 3 Steps
Focus on initial versus complication first. When your urologist performs a hypospadias...
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Secondary Procedures - May or May Not Be Separately Reportable or Reimbursed
14040 — Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mout...
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ICD-10:
Expect Additional Hypospadias Diagnostic Codes
Make sure you look for the defect location. When your urologist performs a hypospadias...
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News You Can Use:
You Can Stick with 59 For Now, CMS Says
CMS is giving software entities time to update their systems. If you are still waiting...
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Reader Questions:
Stick with Original Diagnosis for Next-Day Repeat Stent Insertion
Question: A patient had a cystoureteroscopy laser lithotripsy with stent placement....
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Reader Questions:
Choose Artificial Construction Code For Intestinovagioplasty
Question: One of my doctors emailed me about a procedure she has not yet performed but n...
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Reader Questions:
Check Technical vs. Professional PVR Components
Question: Can we bill 51798 for a PVR if our physician is at a satellite clinic and...
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Reader Questions:
Don't Code for Script Writing
Question: Can I use 99499 to report writing a prescription? Rhode Island Su...
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Reader Question:
Be Sure to Attach GZ With ABN
Question: A Medicare patient came into our practice to see his urologist. The physi...
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Reader Question:
Following the Urologist Likely Means Established Patient
Question: We have several new urologists starting with our practice. Some of their ...
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Reader Question:
Manual Manipulation Equals E/M Only
Question: My urologist saw a patient with testicular torsion. He was able to manipulate ...
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Reader Question:
Check Global Period Before Coding 51040
Question: If a patient has an SP tube placement (51040) and comes in monthly for tu...
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Reader Question:
Code Based on Specific Adhesions Location
Question: My urologist performed the following procedure, and the doctor suggested ...
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You Be the Coder:
Meatus Resection Coding
Question: My urologist’s operative note states that the physician resected th...
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Urology Coding Alert - 2015; Volume 17, Number 5
Radiology Roundup:
3 Tips Clear Up Radiology Coding For Urology Practices
Get the scoop on limited vs. complete. Radiological imaging is a given in urology prac...
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ICD-10:
Get to Know Your ICD-10 Malignant Neoplasm Code Rules
Watch out for metastasis rules. If your urologist treats patients with cancer, you&rsq...
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News You Can Use:
Rejoice in SGR Elimination
Decision also means ICD-10 will move forward this year. Unfortunately, it was no April...
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Payer Pointers:
Clear Up 6 Common Coding Misconceptions With Advice Direct From NGS
Watch for errors with MDM, X{EPSU}, PQRS, and more. Still looking for modifiers X{EPSU...
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Reader Questions:
Pay Attention to Consultation Requirements
Question: A new patient came to see a urologist in our practice to discuss whether ...
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Reader Questions:
Carve Out Separate Adrenalectomy Work
Question: In CPT®, 60545 is the code to report when you excise a retroperitoneal ma...
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Reader Question:
Tap XS for Bladder + Urethral Injections
Question: The doctor went in and injected Botox in the bladder wall and then inject...
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You Be the Coder:
Capture Bladder Cuff Excision
Question My physician performed a ureteroneocystostomy with bladder cuff excision a...
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Urology Coding Alert - 2015; Volume 17, Number 4
Endourology:
Scour the Documentation to Avoid Losing $720 on PCNL Procedures
Don’t miss additional reportable procedures that bring in deserved reimbursement. ...
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ICD-10 Transition:
Step Up Your ICD-10 Preparation with Testing Dates
Choose acknowledgement or end-to-end testing. Whether your urology practice has been p...
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Clip and Save:
Pay Attention to Slight Flu Shot Code Changes for 2015
Even if you only have to report one immunization this year, make sure you won’t fo...
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Reader Question:
Cancer Diagnosis Without Biopsy
Question: We have an elderly patient who my doctor doesn’t want to subject to...
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Reader Question:
Home in on Urology PQRS Measures
Question: When we report to Medicare, what PQRS measures should we be using now tha...
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Reader Question:
Stress HIPAA Compliance at Your Front Desk
Question: I was at my own PCP office, and when I went to stand at check in, there w...
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Reader Question:
Check Specialty Designations for Multiple Encounter Billing
Question: I work in a practice that has multiple specialties, including urology. So...
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Reader Question:
Pay Attention to Consultation Requirements
Question: A new patient came to see a urologist in our practice to discuss whether ...
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You Be the Coder:
Ligation of Accessory Gonadal Vein
Question: I am looking for a code for ligation of accessory gonadal vein and scar a...
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Urology Coding Alert - 2015; Volume 17, Number 3
Office Procedures:
Follow 4 Steps to Successful Testosterone Pellet Implantation Coding
Get to know your payers’ policies or you may give away part of the service for fre...
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ICD-10:
Get Specific With UTI Details in the Fall
The unspecified code is probably not going to be good enough in the near future. When ...
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News You Can Use:
Take Advantage of HPI/Exam Mixing Allowance for E/M Calculations
Review a clinical scenario to drive the point home. Calculating the level of evaluation a...
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Reader Question:
Capture Payment for Emergency Ureteral Repair
Question: I placed a mid urethral sling 57288 on a patient on 1/14/15. This was at ...
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Reader Question:
S2900 Won't Likely Earn You Extra Payment
Question: How would I report a robotic-assisted exploration and drainage of a vesic...
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Reader Question:
Count Intestinovaginoplasty as an Artificial Construction
Question: My urogynecologist said she is planning to perform an intestinovaginoplas...
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Reader Question:
Report the Most Accurate Penile Surgery Code
Question: What would we report for preputioplasty? This is a limited dorsal slit wi...
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You Be the Coder:
2 Instillations, 1 Encounter
Question: Can we bill two instillation codes in a scenario with the following documen...
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Urology Coding Alert - 2015; Volume 17, Number 2
CPT® 2015:
Update Your UroLift® Coding or Face 2015 Denials
New codes 52441, +52442 will be your go-to answers. You haven’t had a code to ac...
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Focus on the UroLift® Reimbursement Impact
Determine whether in-office performance is profitable enough for your practice. Now th...
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ICD-10:
Home in on 1 ICD-10 Code to Support Your UroLift® Claims
One BPH code replaces three come October. When your urologist performs a UroLift® ...
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Compliance:
Implement 7 Compliance Strategies To Comply With ACA Requirements
These tips from OIG’s chief medical officer should keep your practice out of the c...
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Follow This Compliance Director's Advice
As you use Dr. Taitsman’s advice to create a compliance plan, keep the following q...
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Reader Question:
Assignment Doesn't Mean No Patient Pay
Question: We have a patient who is new to Medicare asking why she has to pay anythi...
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Reader Question:
Ask Your Payer for PA S&I Clarification
Question: Can a PA read and interrupt a test such as a uroflow and PVR and be paid ...
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Reader Question:
Pay Attention to DOS for Secondary Stone Removal
Question: We have a patient who had an ESWL and then came to the urologist’s ...
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Reader Question:
Reduce Employee Sickness in Your Office
Question: This time of year we have several employees in the office getting sick. W...
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Reader Question:
Patient Error Won't Prevent Timely Filing Issues
Question: Our patient gave us her Medicare card but said Medicare was her secondary...
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You Be the Coder:
Open Urethral Biopsy, Cystoscopy at the Same Encounter
Question: Our urologist performed a cystourethroscopy with urethral biopsy. The bio...
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Urology Coding Alert - 2015; Volume 17, Number 1
Procedure Coding:
Capture Circumcision Compensation With 3 Coding Tips
Scour the documentation to find the ‘proof’ to support your claim. Most ur...
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ICD-10:
Update Your Phimosis, Balanitis Diagnoses for 2015
Don’t expect a straight 1-to-1 transition. Urologists often perform circumcision...
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Global Surgical Package:
Decipher What Global Period Eliminations May Mean to Your Urologist
Be aware of the negative side effects for patients. You read about CMS’s proposa...
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Urological Pathology Spotlight:
Expect Less Reimbursement for Prostate Biopsy Pathology Work Next Year
Skip G0417-G0419 for Medicare. If your urology practice has a histology technici...
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Reader Question:
Check With Facility on 2-Provider ER Visit Coding
Question: Our doctor was called into the ER and dictated a consult with the locatio...
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Reader Question:
Turn to Unlisted Code for 3D Translabial US
Question: Our urogynecology provider is entertaining the idea of performing 3D tran...
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Reader Question:
Stop Looking for V and E Codes in ICD-10
Question: I’ve heard that ICD-10 doesn’t have an equivalent to V codes ...
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Reader Question:
Provider-to-Provider Conversations Don't Violate Patient Privacy
Question: Our urologist wants to talk to an oncologist about a patient’s cond...
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Reader Question:
'Gonad' Represents a Testicle
Question: What is the proper code for a laparoscopic gonadectomy in a phenotypic (a...
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Reader Question:
Stick with 51700 for Clot Irrigation
Question: If a provider does a bladder irrigation through a SP tube for multiple ob...
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You Be the Coder:
Robotic Mullerian Cyst Excision
Question: I have a question about coding a robotic excision of Mullerian duct cyst ...
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