1. L

    Wiki MDM with 2 history of codes

    I am trying to figure out E/M level here... I was told 2 history of diagnosis are considered stable chronic. So this would be a 99214 due to that and data points. Is this accurate? history of codes being "counted" this way? Can anyone provide any resources? Thank you in advance!
  2. L

    Question UTI's/Hx of UTI's and Chronic Cystitis?

    I'm look for some guidance here regarding documentation for the diagnoses in the subject line. My providers tend to code N30.20 - other chronic cystitis w/o hematuria when documentation states something along the line of: pt seen in consultation for recurrent UTI's, they state a few of the...
  3. L

    Wiki R39.14 vs R33.8

    Here is an example of documentation with some of our providers: They also sometimes say something like: PVR of 68 mL indicating incomplete bladder emptying. Here is the link that I am referring to...
  4. L

    Question neobladder ICD-10

    I'm having a hard time finding an accurate/proper code for neobladder. Z93.6 is what I have found but I don't agree with that code since it's considered an opening. Can someone provide some direction?
  5. P

    Wiki MRI Prostate Fusion Biopsy

    What code are you reporting for MRI prostate fusion biopsy? I know that there is no specific code for this procedure. I have been reporting 55700. I was recently told to report 55899 instead. However, Medicare does not pay us on unspecified codes ending in 99. Just curious as to what others are...
  6. A

    Question 14040 in penile surgery

    I am really new to Pediatric Urology and have a question. I know that 14040 may be billed when skip flaps are used to cover defects. 1. Coming from some background general surgery and oculoplastics, I'm stuck on the idea that flap/defect sizes have to be documented, but feel like there should...
  7. T

    Question Open Cystolithotomy?

    Looking for a code for this.. I've seen 52317/51040 for lithopaxy, but since the stone was removed in this case maybe 52315/51040? I've also been looking at 51065 but it's a bladder stone not a ureteral stone. Foley cather was placed into bladder to straight drain. Bladder was emptied. Was...
  8. T

    Question NPP Nurse Practioner Licensing

    Is it within Licensing Guidelines for a NPP (PRNA) to interpret & sign off on 51798 PVR Bladder Scan (technically a radiology code) when NO Physician in office performed by back office (LPN/MA) for diagnostic purposes in office? Is this something that will be denied in an audit and is it...
  9. A

    In office turned into outpatient procedure

    pt came into the office on a Friday in retention. In the office, provider performed urethral dilation with attempted catheter placement. STill unable to place cath so we went to MHG. 1st attempted with local anesthesia only. cysto with urethral dilation. STill unsuccessful at getting...
  10. T

    Wiki 99211 , 96372 coding when patient brings his own Testosterone Medication

    I work for a Urology Practice. The patient brings his own medication for Testosterone. We are questioning coding for 99211 &/or96372. The nurse is injecting medication the patient brings to office. In the Office note signed by the MD it is documented as there is HPI, PQRI, Allergies, Medication...
  11. T

    Question 51700 with 51703

    I have a question I need confirmation on. 51700 & 51703. Our scrubbing program has terminology that I want to clarify. 51700 is the 2ndry procedure to 51703 therefore it is the one bundled and should not be billed with 51703? Usually the cath's are the 2nday procedure and are bundled with a...
  12. P

    Wiki Urology coding question

    Medicare is denying payment for coaptite injection using 51715. It seems that they do not like any of the incontinence diagnosis codes but that is all the doctor describes as far as diagnosis. Does anyone else have this problem? Or is there any other diagnosis code I could possibly use?
  13. H

    Question Physician coding for outpatient procedure

    Can anyone give me suggestions for coding and billing this scenario. My patient has a procedure done in the office every month code 53855 (urethral stent change) . The physician performed a different procedure for another diagnosis/reason in the hospital as an outpatient (22) on this patient...
  14. P

    Wiki CPT 52441 + 52442 BCBS

    Has anyone received reimbursement for cpt 52441+52441. We have been billing this procedure and it keeps getting denied as investigation/not medically necessary. This is for BCBS in the state of NY. Has anyone else been having issues? If so please provide any guidance. Thank you.
  15. 1

    Clarification Regarding CKD Stages

    Hi, if different CKD stages are present in Medical Record , which Stage we can capture? ex: PMH- ckd stage 2, Assessment: 1. chronic kidney disease stage 3 2. Acute Renal Failure 3. CKD stage 4 Now what are the codes can we capture?
  16. T

    CUC Exam Prep & References

    I am studying for the CUC Exam and want to make sure if the AMA CPT Coding Essentials for Urology & Nephrology 2018 is approved to take in to the test as a reference book. I understand the CPT & ICD10CM are used and I am prficient with those books but find I use this book a great deal in the...
  17. S

    Wiki SNF and Office Procedures

    We do urinary testing in office. We tested on a SNF patient. Medicare is now requesting their money back. Codes are 51798, 51784, 51741, 51797, 51728. Not sure what to bill to who? Any help appreciated. Thank you, Shana Kalista Billing Manager Bend Urology Associates
  18. B

    Wiki Premarin Cream Billing Reimbursement?

    Hello We have a doctor we are looking to do procedures at an ASC and is going to use Premarin vaginal cream during some surgical procedures. Is there a code to bill for the Premarin cream, possibly a J code? The ASC is trying to determine how they will get reimbursed for the cost of the cream...
  19. L

    AmnioFix injection into stricture

    what CPT code would you use for AmnioFix Injection into urethral stricture? would you use 52283? even though it's not technically a steroid? Or should I just use 52281 for the balloon dilation? Obviously I can't use both. PROCEDURE: In the dorsal lithotomy position under general...
  20. C


    We were approached by a representative with Laborie regarding a device called Urostym. He stated if we had our own Urostym device and equipment we could bill for pelvic muscle rehab in our office. We were informed an RN or even an MA could perform the muscle rehab with the Urostym equipment...
  21. T

    MRI FUSION FOR PROSTATE BIOPSY in OFFICE question CPT billing-2 questions

    We perform MRI FUSION prostate biopsies in Office setting with a Radiologist that comes in 1x month bringing/using the MRI image disk and Fusion Program that we rent to use and pay him per patient. There is a question of the billing for this by our office. 1.We have been billing 55700...
  22. B

    E&M and 51798_modifier

    Hi Please can anyone tell , which modifier we can use with 99214 and 51798 . 51798 is done by urology technician and interpretation has given by urologist , To avoid any denials Help !!!!
  23. D

    CPC-A Michigan

    Hello I have an associates degree in Health Administration and have worked as a surgical scheduler for Urology for 7 years. Sherita Mitchell CPC-A domoniquem@sbcglobal.net
  24. J

    Wiki Removal Suprapubic Indwelling Catheter

    Looking for help coding the permanent removal of a suprapubic indwelling bladder catheter. I can find the code for insertion of this type of catheter, but nothing on the removal. Would my only option be the 53899 for Unlisted procedure, urinary system?
  25. O

    CRNA Experience

    Hi everyone, I have just recently become a cpc and i have just starting doing coding for a group of certified registered nurse anesthetists, if anyone has any experience in this area, I would love to hear from you. Our CRNA's do work for a few gastroentrology places and 2 urology centers, if...