Urology Coding Alert
Say Goodbye to Inappropriate Payments for Urodynamic Studies
Question: I am with the billing office for a urologist and am having an issue with reimbursement for urodynamics. Our office is billing for 51798, 51741, 51726 based on the doctor's instructions. The payer isn't reimbursing correctly on the cystometrogram with voiding pressure. They are paying less than cystometrogram alone. Am I coding incorrectly?
Florida Subscriber
Answer: In 2010 and 2011 the relative value units (RVUs) were erroneously higher for code 51726 (Complex cystometrogram [ie calibrated electronic equipment]), than they were for the more complicated 51728 (Complex cystometrogram with voiding pressure studies [bladder voiding pressure] ...). This resulted in inappropriately higher payments for 51726 than for 51728.
This was a mistake on the part of CPT® and will be corrected on Jan. 1, 2012. In 2012, RVUs have been corrected and 51728 will have RVUs of 9.24 while 51726 will have RVUs of 8.61 effective Jan. 1, 2012.
Urology Coding Alert
- 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 [...] - 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 [...] - 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 [...] - 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 [...] - You Be the Coder:
53899: New Prostate Ablation Technique Requires Unlisted
Question: My doctor performed ablation of the prostate using irreversible electroporation. I have never heard [...] - 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 [...] - 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 [...] - 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 payments but [...] - 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 [...] - Reader Question:
Review Retrograde Urethrogram Coding Requirements
Question: I have run into some notes that state that the physician performed a retrograde [...]
