Urology Coding Alert
Identify Base Codes Quickly and Easily With CMS Fee Schedule
Look to column AD for multiple-endoscope guidance Once you know how to apply the multiple endoscopy rule, you need to know which codes to apply it to. There's a fast and easy way to determine if a code is a base code: Consult the Medicare Physician fee schedule (PFS), says Jill Young, CPC-EDS, CPC-IM, of Young Medical Consulting in East Lansing, Mich. Where to look: You can download the PFS for free from the CMS Web site at http://www.cms.hhs.gov. Be sure to download the "PFS relative value files" version. Navigate the file: After downloading the PFS, you can open an Excel file that lists all the CPT codes in numerical order. To identify an endoscopic base code, look to column AD (labeled "Endo Base"). Column AD shows you the endoscopic base code for the code that appears in column A. Note: If there is no code in column AD, the code in column A is the base code or is not an endoscopic procedure code at all. Example: Select 52354 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration or ureteral or renal pelvic lesion) in column A. If you then look at column AD, you see that the endoscopic base code for 52354 is 52351 (... diagnostic). Bonus: The chart below has the endoscopic code families you're most likely to deal with in urology.
Urology Coding Alert
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