Hi All!
We have a new doctor joining our group who does stuff none of the other 30 providers in my group does. So he raised some questions I didn't even anticipate! ANY help anyone can give is VERY appreciated!!
1. Surgical microscope (mainly for TESE/TESA) - does it add enough RVUs (3.46) to be significant enough to bill or is it more useful as a tracking code like S2900?
2. Does anyone bill for activation of prosthesis (penile, AUS, etc) codes? I always thought it was part of the surgical package.
3. Artificial erection is 54235 - is it the same code for detumescence? Or is that not billable because it's assumed if you put it up, you gotta take it down?
(my logic says the latter)
4. When he puts in an IPP, he makes a penoscrotal incision, so he basically does a Dartos Flap at closure, it's billable but it becomes the primary procedure, so is it more of a judgement call on the surgeon on how significant to the procedure it is to make it billable?
5. Needle biopsy of testes to check for sperm - is it usually payable for azospermia (sp?) or ogliospermia? He's doing it to mainly see if there is sperm to determine of there's a blockage causing the infertility. I know that anything with an infertility diagnosis on it is not usually covered by insurance and would be cash pay, but if there's a case for it where we can bill it, what are those common instances?
We have a new doctor joining our group who does stuff none of the other 30 providers in my group does. So he raised some questions I didn't even anticipate! ANY help anyone can give is VERY appreciated!!
1. Surgical microscope (mainly for TESE/TESA) - does it add enough RVUs (3.46) to be significant enough to bill or is it more useful as a tracking code like S2900?
2. Does anyone bill for activation of prosthesis (penile, AUS, etc) codes? I always thought it was part of the surgical package.
3. Artificial erection is 54235 - is it the same code for detumescence? Or is that not billable because it's assumed if you put it up, you gotta take it down?
(my logic says the latter) 4. When he puts in an IPP, he makes a penoscrotal incision, so he basically does a Dartos Flap at closure, it's billable but it becomes the primary procedure, so is it more of a judgement call on the surgeon on how significant to the procedure it is to make it billable?
5. Needle biopsy of testes to check for sperm - is it usually payable for azospermia (sp?) or ogliospermia? He's doing it to mainly see if there is sperm to determine of there's a blockage causing the infertility. I know that anything with an infertility diagnosis on it is not usually covered by insurance and would be cash pay, but if there's a case for it where we can bill it, what are those common instances?