Urology Coding Alert

Test yourself with these 5 questions about the edits, deletions and additions If you’re still trying to get a grip on the Jan. 1 CPT Changes, take this quiz. These questions will test just how well you understand the new drug administration changes and the new cryoablation and renal pelvis catheter codes. Turn to page 14 to see the answers. Hint: You can find all the quiz answers in the CPT Updates 2006 articles in the December 2005 issue. Question 1: True or false: You can expect higher reimbursement using the new permanent drug administration codes 90765, 90772 and 96402 than you did with the G codes you used before. Question 2: If your urologist administers a Depo-Testosterone injection, what code should you report for the drug administration? A. G0347
B. 90765
C. 90772
D. 96402
E. None of the above Question 3: Your urologist performs a percutaneous radiofrequency renal ablation in the hospital on the patient’s right side, using magnetic resonance imaging (MRI) to monitor the tumor’s response to the percutaneous radiofrequency. What is the correct way to code this procedure? A. 50592
B. 50592-50
C. 50592 and 76940-26
D. 50592 and 76394-26
E. None of the above Question 4: Which CPT code should you report when a urologist removes a prosthetic vaginal graft via a vaginal incision? A. 57267
B. 57295
C. 58999
D. 50688
E. None of the above Question 5: An internist requests that a urologist perform a consult in the hospital for a patient with an elevated prostate specific antigen (PSA, 790.93). Later during the same inpatient stay, the urologist checks again on the patient and provides subsequent urological care. Which of the following coding scenarios might be appropriate for reporting these visits in 2006? A. 99253 for the first visit and 99261 for the second
B. 99261 for the first visit and 99231 for the second
C. 99253 for the first visit and 99231 for the second
D. All of the above
E. None of the above


Answer 1: False. Urologists will be paid about 7 percent less than last year when using the new administration codes. For example, based on the 2005 and 2006 physicians’ standard unadjusted fee schedule, instead of a $36.69 reimbursement for G0356, you’ll receive about $34.01 for code 96402 in 2006, which is about 7.3 percent less.

Remember, this is based on the loss of the 3 percent transitional increase that physicians received in 2005 (discontinued in 2006), the change in the conversion factor, minor changes in the relative value units (RVU), and the [...]