Urology Coding Alert

Combine research and billing system edits to boost accuracy.To stay on top of Medicare's constantly changing Provenge coding rules, you need a solid strategy.One place to start is the manufacturer's website, says Lisa S. Martin, CPC, CIMC, CPC-I, chargemaster specialist for OSF Healthcare System in Peoria, Ill. "Take advantage of their specialized knowledge and assistance when offered, especially when an office or facility initially starts using the product," Martin says. You'll find the website at www.provengereimbursement.com/.Of course, you will want to check what the manufacturer says against payer policies. You can search your payer's site, or the Provenge reimbursement website, which offers links to "state-specific coverage information, and there is an external link to the Medicare NCD [National Coverage Determination] from their website, which also contains very specific information" says Martin. Provenge policies are indeed very specific, so reading the national and local policies in full is important. For instance, [...]