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Urology Coding Alert

Reader Questions:

Cysto + Care Coordination May = Separate E/M

Published on Sat Jan 16, 2010

Question: A urologist performs a cystoscopy and then reports the results to the patient or informs them of their options. Should I consider the discussion in the cystoscopy reimbursement? Or can I bill an E/M charge as well? Michigan Subscriber Answer: With any service, procedure, or diagnostic test, if the results are normal and the urologist simply meets with the patient to tell him that the results were normal, then you should include that in the coding for the test/procedure/etc. -- in this case, the cystoscopy, such as 52000 (Cystourethroscopy [separate procedure]). Exception: If the cystoscopic examination uncovers a problem and your urologist spends a significant amount of time with the patient explaining the results, the treatment options, the plan of care, etc. you may be justified in billing a separate E/M service code, such as 99213 (Office or other outpatient visit for the evaluation and management of an established patient [...]
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