Urology Coding Alert

Plus: Don’t miss the update to urology code 54640.

CPT^® code additions, deletions, and revisions for 2020 will go into effect when January rolls around, so now’s the time to familiarize yourself with any changes that might come into play for your practice. Fortunately, urology doesn’t have as many updates to consider as some specialties, so you won’t need to make many changes to your superbill or billing software.

That said, there are some updates with which you should get familiar. Here’s what you need to know to be ready for the new year.

Get Ready to Go Digital

As healthcare continues to become more digitized, coding changes are mirroring the trend. You’ll come across several new codes related to digital E/M services in 2020. The first set applies to nonphysician providers:

• 98970 (Qualified nonphysician health care professional online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes)
• 98971 (… 11-20 minutes)
• 98972 (…21 or more minutes).

The same services have corresponding codes for physicians:

• 99421 (Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes)
• 99422 (… 11-20 minutes).

“Check your 2020 CPT^® manual for when, why, and how these new E/M codes are to be used,” advises Michael A. Ferragamo, MD, clinical assistant professor of urology, State University of New York Stony Brook.

Catch This Important Revision

Only one revision will be of particular interest to urology practices, according to Ferragamo. The descriptor for 54640 will change from Orchiopexy, inguinal approach, with or without hernia repair to Orchiopexy, inguinal or scrotal approach.

“This revision will provide a code for a trans-scrotal orchiopexy, such as for retractile testicles that are descended but require fixation to the bottom of the scrotum to prevent their upward migration,” Ferragamo explains. “Upward migration often leads to recurrent scrotal pain and possible testicular atrophy if the retraction continues over a prolonged period of time.”

Plus: The revision indicates that a hernia repair (represented by codes 49495-49525) can now also be billed if performed in conjunction with the orchiopexy.