Urology Coding Alert

While in-facility urologists are losing money on cystoscopy and treatment procedures, in-office urologist fees have skyrocketed, increasing more than 150 percent and this isn't the only in-office advantage of its kind. Large increases in the 2002 physician office fees for certain urological procedures stand out as the minority amid a majority of fee cuts that affect urological procedures. With the 5.4 percent decrease in the 2002 national Physician Fee Schedule conversion factor from 38.2581 in 2001 to 36.1992 urologists have experienced a big decrease in payment for many of their more popular services. Although the physicians performing in-facility services have been hit harder by the payment decreases, physicians performing some office services, e.g., treatments of bladder lesions (51720) and insertions of urinary catheters (53670), two procedures whose payments have decreased by more than 30 percent, have also noticed the impact of the fee cut. For those urology coders who see the glass as half full, there have been some very noteworthy increases in some in-office services including:
52000 (Cystourethroscopy [separate procedure]) increased 8.86 percent increase from $185.55 in 2001 to $201.99 in 2002
51741 (Complex uroflowmetry [e.g., calibrated electronic equipment]) increased 11.15 percent from $102.91 in 2001 to $114.39 in 2002
55700 (Biopsy, prostate; needle or punch, single or multiple, any approach) increased 24.65 percent from $184.40 in 2001 to $229.86 in 2002
51726 (Complex cystometrogram [e.g., calibrated electronic equipment]) increased 14.70 percent from $205.45 in 2001 to $235.66 in 2002
52281 (Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female) increased 164.24 percent from $239.88 in 2001 to $633.85 in 2002. Both the payment increases and decreases urologists are experiencing are a result of the Final Rule for the 2000 Physician Payment Schedule that was published in the Nov. 2, 1999, Federal Register that named Jan. 1, 2002, as the implementation date for the new resource-based practice expense relative value units.