Urology Coding Alert

Presented by Michael A. Ferragamo, MD, FACS The following supplement to Urology Coding Alert is the transcript of a teleconference presented by The Coding Institute. To obtain the slides for the conference, please log on to our Online Subscription System at http://codinginstitute.com/login and open the PDF version of the current issue, and the slides will be contained therein. If you’re not sure how to use the Online Subscription System or need help opening the issue, please contact our customer service department at 1-800-508-2582 or service@medville.com, and one of our representatives will be able to assist you.

The speaker for the teleconference, Michael A. Ferragamo, MD, FACS, is the former chief      of Urology of Hempstead Medical Center and of Franklin Medical Center of Long Island, New York. He is currently assistant clinical professor of Urology at the State University of New York, Stony Brook School of Medicine. Ferragamo is a consultant on coding and reimbursement for the Physicians Reimbursement Systems (PRS) in Denver and is a Consulting Editor for Urology Coding Alert. Thank you very much Erika and good morning to all our loyal subscribers and my friends.  I welcome you to this conference.  I hope that you have all received the handout with a copy of the slides that we will be using during this presentation.  Each page will contain two slides. 

Page 1, slide 1.  I would like to start off this teleconference speaking a little bit about the current coding for hormonal treatment of prostatic cancer as a lead-in to the Critical CAP (Competitive Acquisition Program) for Your Urology Practice.  Is this CAP program something that you will want to institute for your office?

Page 1, slide 2.  This slide shows us the 2005 Medicare CPT Codes and fees for drug administration.  The G codes have replaced the 96400, 90780, and 90782.  The 2004 32% transitional increase that we enjoyed last year has been discontinued but in 2005 we have received a 3% transitional increase which will again be taken away from us in 2006.  The code 96400 that we used last year for the IM or subcutaneous administration injection code for Lupron, Zoladex, Trelstar and Eligard which was paying a standard or an unadjusted Medicare fee, unadjusted for the area or state in which you practice, paying $64.07 was changed in 2005 to G0356, paying in 2005 $36.69.  A significant drop of 43%. 

The code 90780 that we used in 2004 for our IV infusions up to an hour, and this is the code that urologists use for their infusion of Zometa.  This was paying an unadjusted fee last year of $117.80, and [...]