Urology Coding Alert
Reader Question:
Vasectomy
Published on Sun Jul 01, 2001
Question: When billing a vasectomy to Medicare and then Medicaid, how should we file?
New York Subscriber
Answer: Code the consultation (992xx) and 55250 (vasectomy, unilateral or bilateral [separate procedure], including postoperative semen examination[s]) and bill to Medicare. Medicare will not pay for the service. Then send the claim, with the Medicare denial, to Medicaid. Medicaid will pay. Report both the consult and the procedure with modifier -GZ (item or service not reasonable and necessary). If your carrier does not recognize modifier -GZ yet, use modifier -GX (service not covered by Medicare).
Other Articles in this issue of
Urology Coding Alert
- Modifiers -62 and -80 Enhance Payment for Cystoprostatectomy With Three Surgeons
A radical cystoprostatectomy with ileocolic urinary diversion, a common urology Procedure requiring more than [...] - Optimize Reimbursement:
Know When to Use Modifier -50 on Cystourethroscopies
Urology coders should distinguish between CPT and Medicare guidelines when appending [...] - You Be the Coder:
Cysto With Washings
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - Diagnosis Code Drives Payment for Circumcisions
Reviewed on May 27, 2015
Adult or adolescent circumcision is common, but if [...] - News Brief:
Carriers Make Own Bundling Edits for Ureteroscopy Codes
New ureteroscopy codes were introduced in 2001, but in the most recent Correct Coding Initiative [...] - Clarification:
You Can Use 52640 for Treating Bladder Neck Contraction
In an article on treating bladder neck contracture by incision in the May 2001 issue [...] - Reader Question:
Vasectomy
Question: When billing a vasectomy to Medicare and then Medicaid, how should we file?
New York [...] - Reader Question:
Cystourethroscopy and Stent
Question: Our claim check software makes 52332 (cystourethroscopy, with insertion of indwelling ureteral stent [e.g., [...] - Reader Question:
Complex Renal Cyst
Question: Which diagnosis code should I use for complex renal cyst? Nothing in the ICD-9 [...] - Reader Question:
Suprapubic Catheter
Question: The patient had a suprapubic catheter. The doctor was called in for a consult, [...] - Reader Question:
Laparoscopic Burch Procedure
Question: How should we code for a laparoscopic Burch procedure, a laparoscopic enterocele repair, a [...] - Reader Question:
Sling Operation
Question: When the doctor performs 57240 or 57288, can we bill for [...] - Reader Question:
Urgency
Question: When I see urgency in the chart, Im not sure which diagnosis code to [...]
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