Urology Coding Alert
Stop Losing $15 Per Iliac Node Biopsy
Question: The urologist says he biopsied the iliac node. I can't find a code for this procedure. What should I use? Oregon Subscriber Answer: You should use CPT 38562 (Limited lymphadenectomy for staging [separate procedure]; pelvic and para-aortic) if your urologist's documentation indicates that he performed a simple excision of one or more pelvic nodes. However, if he only performed a biopsy of a lymph node, report 27041 (Biopsy, soft tissue of pelvis and hip area; deep, subfascial, intramuscular) instead. Don't lose money: If you're not checking for an excision, and you're just reporting 27041 for this procedure, you could be costing your practice money. Code 38562 reimburses $650.64, and code 27041 reimburses $635.85 (2009 unadjusted rates based on the Medicare fee schedule).
Urology Coding Alert
- Case Study:
Mind Your Modifiers When Your Urologist Works With Another Doctor
Automatically appending modifier 52 could be costing you hundreds. When your urologist works with another [...] - 52 vs. 53
Modifier 52 (Reduced services): Modifier 52 applies when "a service or procedure is partially reduced [...] - 62 vs. 80
Modifier 62 (Two surgeons): You should look to modifier 62 when your urologist participates in [...] - Clip and Save:
Capture Orchiopexy and Hernia Repair Pay With This Chart
Let the surgical approach guide your code choices. As explained in "Mind Your Modifiers When [...] - Is This Biopsy Mistake Costing Your Practice Hundreds?
Tip: Look beyond the term 'fulguration' when you choose your codes. If you're billing every [...] - You Be the Coder:
Stop Losing $15 Per Iliac Node Biopsy
Question: The urologist says he biopsied the iliac node. I can't find a code for [...] - Reader Questions:
CPT Doesn't Offer 53515 Specifics
Question: How should I code for a repair of a prostate laceration using sutures? The [...] - Reader Questions:
Does Lack of Cysto Affect Code Choice?
Question: What is the proper code for a urethroscopy with fulguration of a small intraurethral [...] - Reader Questions:
Prepare to Justify Unlisted Thrombectomy Coding
Question: My doctor did a hand-assisted laparoscopic radical nephrectomy with vena cava thrombectomy, exploratory laparotomy, [...] - Reader Questions:
Include Prostate Massage With E/M
Question: My doctor is doing a test called PSA3. We are considering doing this in [...] - Reader Questions:
You Won't Need to Unbundle Therapy Codes
Question: We have a new doctor and new nurses who are performing pelvic floor therapy [...]
