Urology Coding Alert

Case Studies:
Sharpen Your Radical Cystectomy Coding Skills With This Example
Get useful tips and billing advice on your way to the correct code set. There are plenty ... Read more
ICD-10-CM:
Highlight These Overlooked 2021 ICD-10-CM Guidelines
Home in on a few key guidelines pertaining to diabetes, medical observation, and more. Fr... Read more
Proposed Rule:
Consider Multi-Specialty Monetary Impact of MPFS 2021 Proposed Rule
See how urology weathers the storm with an unlikely increase in net revenue. As you wor... Read more
You Be the Coder:
Strictly Follow the Index With This Cystourethroscopy Example
Question: A patient with interstitial cystitis presented to the ambulatory surgery center ... Read more
Reader Questions:
Learn These 5 Levels of Medicare Appeals
Question: I submitted a claim to my region's Medicare Administrative Contractor (MAC... Read more
Reader Questions:
Make Crucial Distinctions Between Excludes 1, 2 Notes
Question: I am still confused by the Excludes1 and Excludes2 instructions in ICD-10. ... Read more
CPT® 2021:
Get All the Pertinent 2021 CPT® Updates With This Guide
Cover all your bases with this review of new, revised, and deleted codes. In a year prece... Read more
CPT® Coding:
Stay on Top of In-Office CT Scan Coding Rules, Guidelines
Plus, know when it's appropriate to bill for contrast imaging agents. When a physician pr... Read more
Compliance:
Focus on These Important ABN Form CMS-R-131 Details
Compare and contrast changes to ensure a smooth transition. With the recent CMS update of... Read more
You Be the Coder:
Take Payer Policy Into Account With Modifier 59 Usage
Question: A patient had a transrectal ultrasound (US) that resulted in ultrasound-guided b... Read more
Reader Questions:
Don’t Mistake Correlated Dx With Definitive Dx
Question: I know all about avoiding the coding of diagnoses using probable, suspected, and... Read more
Reader Questions:
Stay on Top of Rules for Telehealth to In-Person Transition Visits
Question: If a visit starts as telehealth and the patient then comes to the office for an ... Read more
Reader Questions:
Be Aware of Crucial Updates to Medicare LCD for Diagnoses
Question: We've always turned to our Medicare contractor's LCDs to find a list of payable ... Read more
E/M 2021:
Highlight All the E/M Essentials for CPT® 2021
See how new codes and revised descriptors will influence your coding choices. Just as you... Read more
ICD-10-CM Guidelines:
End the Excludes1 Coding Hassle With Conclusive Guidelines
Put this coding conundrum to rest once and for all. As you work your way through the ho... Read more
NCCI:
Get Details on This Lesser Known Sequential Procedures Guideline
Enhance your skills by utilizing guidelines from all corners of the coding universe. Th... Read more
You Be the Coder:
Channel Guidelines, CPT® Knowledge for this In-Office Encounter
Question: What's the CPT® code for an in-office visit for a newborn patient that requires... Read more
Reader Questions:
Consider Modifier Switch for Bilateral Billing of 1 MUE Codes
Question: Why might I be receiving a denial for frequency when submitting two units of a 5... Read more
Reader Questions:
Note Expanded Deadline for ABN Form CMS-R131
Question: I was told by a colleague that there's a new Advance Beneficiary Notice (ABN) fo... Read more
Reader Questions:
Confirm CPT® Guidelines on New, Existing Patients for New Practice Visits
Question: I am aware of the new patient rules for E/M visits, but this situation is a new ... Read more
ICD-10-CM 2021:
Get Up to Speed on All Relevant Urological ICD-10-CM 2021 Changes
Make sure to look beyond the new, revised, and deleted codes. Continuing education is a n... Read more
Bilateral Billing:
Boost Knowledge, Improve Proficiency With Analysis of Bilateral Surgery Indicators
Plus, know exactly where to go to find your code's indicator. The process of appending ... Read more
Provider Relations:
Improve Physician Queries Using These Effective Tactics
Improve working relationships to ensure accuracy and reduce future errors. Communication... Read more
Reader Questions:
Look Out for Spectral Analysis Synonyms on Duplex Scans
Question: On a scrotal ultrasound (US) with duplex scan, the provider documents in the dup... Read more
Reader Questions:
Take Note of Alternative Commercial Payer Modifier CS Guidelines
Question: Our payer has a guideline regarding modifier CS (Cost-sharing for specified... Read more
You Be the Coder:
Summon Your Knowledge of NCCI, Global Periods to Code This Service
Question: A few days following a right percutaneous nephrolithiotomy, a patient returned t... Read more
CPT® Coding:
Refine Your Knowledge of Catheter Coding Guidelines With This Example
Don't rush to judgement until you've got all the facts. Every surgical specialty has a se... Read more
E/M 2021:
Gain Crucial Insights on Time-Based E/M Coding in 2021
Know when to bypass the 50 percent counseling/coordination of care requirement/threshold. ... Read more
Modifiers:
Get the Scoop on Cost-Sharing Waiving With Modifier CS FAQs
Meet this specific set of criteria to waive cost-sharing on eligible services. As summer ... Read more
Reader Questions:
Consider Edits Between Percutaneous Nephrostolithotomy and Associated Procedures
Question: A report for a patient with kidney stones states that a stiff glidewire was adva... Read more
Reader Questions:
Pinpoint Operative Report Specifics for Hydrocelectomy and
Question: What's the code for a hydrocelectomy when it's performed with an incarcerated he... Read more
You Be the Coder:
Make Appropriate Inferences From 50432 Code Description
Question: A patient presents to the emergency department (ED) with dysuria and renal ... Read more
CPT® Coding:
Master Cystourethroscopy Coding With These Case Studies
Maneuver between guidelines and expert advice to drive the point home. A surgical special... Read more
Consultation:
Navigate Your Way Through the Consultation E/M Coding Process
Get providers on both sides of the aisle their deserved reimbursement. The frequency in w... Read more
E/M 2021:
Discern E/M 2021 Fact from Fiction With These True/False Questions
Stay ahead of the curve as the new year quickly approaches. Knowing where to begin planni... Read more
Reader Questions:
Garner a Fighting Chance at Modifier 22 Reimbursement
Question: I'm having trouble securing any extra payment when appending modifier 22 to... Read more
Reader Questions:
Compare and Contrast Modifiers 52, 53
Question: What guidelines should I adhere to for a surgery cancelled midway because o... Read more
You Be the Coder:
Use This Guidance for Immunosuppressant Visits During Global Period
Question: Can my urologist bill for immunosuppressant visits during the global period... Read more
CPT® Coding:
Learn Essential Rules for Laser Prostatic Treatment Coding
Look out for key words in the operative report to discern between codes. Laser treatment ... Read more
NCCI:
Consider This New Set of Urology-Related NCCI Changes
Dive into new, revised, and deleted NCCI pairings. Staying ahead of all the annual coding... Read more
Modifiers:
Get Up to Speed on Discontinued Procedure Modifiers
Make sure you've got documentation to support your modifier. Finding your stride as a sur... Read more
You Be the Coder:
Consider Global Period, Complications, Follow-Up Surgery Modifier
Question: Our physician performed a cystoscopy, a right retrograde pyelogram, and a right ... Read more
Reader Question:
Separate Urological, Radiological Services on Nephrostomies
Question: A urologist places a nephrostomy catheter under ultrasound (US) and fluoroscopic... Read more
Reader Question:
Take Appropriate Steps For Non-Covered LCD Diagnoses
Question: Does Medicare restrict coverage to only the diagnoses listed under the code's Lo... Read more
Reader Question:
Bundle Catheter Placement into 52450
Question: The surgeon performs a cystoscopy with transurethral incision of the prostate (T... Read more
Telehealth:
Get In-Depth Coverage on New COVID-19 Telehealth Guidelines
Outline components of all four types of virtual service — and their respective codes. E... Read more
Virtual Services:
Focus on Essential Info for Virtual Check-Ins, E-Visits, and More
Lay out the groundwork for three more types of virtual services. Understanding the coding... Read more
Guidelines:
Break Down These Essential COVID-19 ICD-10-CM Dx and Guideline Updates
Home in on sequencing rules, suspected vs. positive cases, and more. The Centers for Dis... Read more
You Be the Coder:
Think Twice Before Coding Urethral Dilation With Cystolitholapaxy
Question: I'm working on an operative report for a cystoscopy in which the provider uses a... Read more
Reader Question:
Continue Existing Patient Billing For New Practice Providers
Question: When a physician joins a new practice and sees patients from the former practice... Read more
Reader Question:
Rely on Payer Guidelines for Extenuating Telehealth Circumstances
Question: If a physician performs a Facetime conversation with a COVID-19 patient fro... Read more
Coding Update:
Countdown to E/M Changes in 2021 Has Begun; Here's Your High-level Look
Hint: Time calculations will be much different in the future. Big changes will be coming ... Read more
Coding Basics:
Pay Attention to Details to Prevent Denials Due to Careless Mistakes
These two things are simple, but have a powerful effect on success. Documentation that g... Read more
Compliance:
Yes, Your Risk Assessment Tool Can Be Unique to Your Practice
Don't worry: You aren't required to follow a certain form. Forms and rule sets are an eve... Read more
You Be the Coder:
Count Parts for Prosthesis Implant Coding
Question: Which code should I report for a two-piece penile implant? I use 54400 for a one... Read more
Reader Question:
Check PSA Status Before Reporting Only C61
Question: We have a patient who had a radical prostatectomy for prostate cancer four years... Read more
Reader Question:
Turn to 51999 for Colovesical Fistula Repair
Question: What is the appropriate code to report a laparoscopic sigmoid colectomy with rep... Read more
Reader Question:
Don't Bill the Payer for No-Shows
Question: My office has had an uptick in no-show patients. One of my coders says that he c... Read more
Reader Question:
Report 74415 Over 74420 for Treatment of Same Area
Question: One of the urologists at our facility documented that while doing a scouting fil... Read more
Reader Question:
Follow Payer Policy on How Often to Report 52648
Question: A patient had two Greenlight vaporizations of the prostate (52648) about 15 mont... Read more
Reader Question:
Follow These Points to Help Protect PHI
Question: I'm always concerned about protecting our patients' health information, especial... Read more
Lab Focus:
Keep These 2 Tips in Mind When Submitting a Urinalysis Claim
Remember that separate E/M code is allowed. No matter how commonplace a test your urologi... Read more
Coding 101:
Know the Ground Rules for Reporting Modifier 53
Hint: Specific details will help bolster your case. No matter how many times a surgeon pe... Read more
Procedure Focus:
Keep These Points in Mind When Counting Stones for Coding
Hint: Start with the number of structures. Coding for multiple urinary stones can seem co... Read more
Reader Question:
Select Ureteroneocystostomy Code Based on Other Services
Question: How should I code an extravesical ureteroneocystostomy the urologist performed l... Read more
Reader Question:
Stick with the Provider's Documentation for Diagnosis
Question: I've got a report without a diagnosis that meets the CPT® code's Local Coverage... Read more
Reader Question:
Hernia Repair Includes Work of Hydrocelectomy
Question: The physician planned to perform a hydrocelectomy but I don't find documentation... Read more
Reader Question:
Ileal Loop Without Cystectomy Leads to 'Unlisted'
Question: Does CPT® include a code for creation of an Ileal loop urinary diversion withou... Read more
Reader Question:
Include Multiple Diagnoses for Immunosuppression Care After Transplant
Question: After a kidney transplant, can the urologist bill for immunosuppression during t... Read more
Reader Question:
Confirm Global Period Days Before Adding Modifiers
Question: The urologist performed a ureteral stent placement. Later that evening he was ca... Read more
You Be the Coder:
Verify This to Determine MMK or Burch
Question: I am new to urology coding and am having trouble distinguishing between an MMK p... Read more
Diagnosis Coding:
Avoid the Trap of Assigning N39.0 for Every UTI Diagnosis
Hit: Check whether other anatomic sites are involved. While a urinary tract infection (UT... Read more
Surgical Focus:
Are You Using These 2 Codes for Penile Repair?
Watch for the type of injury — and don't confuse it with exploration. Coding for penile... Read more
Compliance:
Fitness Trackers Might Have More Regulations Coming
Lawmakers are looking at ways to keep HIPAA on pace with technology. Healthcare apps, fit... Read more
Reader Question:
Remember That 50948 Service Includes 50650
Question: We performed a robotic assisted laparoscopic distal left ureterectomy, psoas hit... Read more
Reader Question:
Turn to D49.59 for Pending PSA Results
Question: How should I code an extravesical ureteroneocystostomy the urologist performed l... Read more
Reader Question:
Add Modifier 62 for Case Involving 2 Surgeons
Question: One of our urologists performed a joint case with a general surgeon which involv... Read more
Reader Question:
Ultrasound Guidance Is Not Separate from Lithotripsy
Question: Is ultrasound guidance and/or fluoroscopy included in the procedure code when my... Read more
Reader Question:
Turn to D49.59 for Pending PSA Results
Question: What ICD-10 code is correct to indicate the pathology is still pending for a pro... Read more
Reader Question:
Code 13160 Applies to Scrotal Wound Dehiscence
Question: I'm attempting to code a case for closure of a scrotal wound based on this docum... Read more
Reader Question:
Report 52317 for Litholopaxy
Question: I'm looking for help coding for an excision of exposed urethral sling mesh via l... Read more
Reader Question:
Shunt Drainage Points to Best Priapism Code
Question: What are the best surgical codes for priapism? I don't understand how to differe... Read more
Reader Question:
Append Modifier 52 When Full Procedure Isn't Performed
Question: The patient's Mitrofanoff stoma stenosed near the bladder end of the stoma. Our ... Read more
You Be the Coder:
Reporting Ureteral Stent Placement Via Ileal Conduit
Question: The urologist placed a ureteral stent via the patient's ileal conduit. He insert... Read more
Procedure Focus:
4 Tips Ensure You're Correctly Coding Botox Injections for Urinary Dysfunction
Warning: Don't assume the diagnosis is overactive bladder. Urologists sometimes opt for B... Read more
Coding Update:
Prepare Now for Fee Schedule Changes Will Affect Your Practice
Here's the latest on what to expect in 2020. There's a lot to interest urology coders in ... Read more
Practice Management:
Be Wary of PHI Disclosures, or Potentially Pay the Price Later
Don't let incidental info sharing get your practice in hot water. Protecting patients' pe... Read more
Reader Question:
Skip Billing Xylocaine Jelly as Local Anesthetic
Question: When our urologists perform a trans-urethral destruction of prostate by rad... Read more
Reader Question:
Include Full Documentation for Circumcision in Office
Question: Our urologist performed a circumcision on an infant during an office visit. Sinc... Read more
Reader Question:
Submit Multiple Units of J9030 for Instillation
Question: Can you explain to me how to code a full-vial dose (50 mg) of BCG treatment for ... Read more
Reader Question:
Report Testosterone Pellets Based on Payer Preference
Question: Our office had been using the Testopel pellets (75mg) and billing with S0189. No... Read more
Reader Question:
Check Before Coding Pelvic Exam Separately
Question: The urologist performed cystourethroscopy, removed the scope, and then performed... Read more
Reader Question:
Don't Be Too Quick to Bill Catheter Supplies
Question: Can we bill for catheters if the patient couldn't be catheterized? The patient w... Read more
Reader Question:
Capture Lysis of Adhesions with Repair With a Single Code
Question: Are lysis of penile adhesions and repair of penile skin bridge the same procedur... Read more
You Be the Coder:
Correctly Report Ureteral Stump Biopsy
Question: I am coding for biopsy of a ureteral stump that seems to have grown into the bla... Read more
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