Wiki New to Urology Coding-Have A Question

[dballard2004]

Hi everyone!

I'm new to urology coding/auditing and I have a question that may sound simple in nature (and I apologize if this comes across as stupid)….when the urologist inserts a catheter in the office, are we allowed to bill for the supplies such as the catheter itself and the tape, etc. with the AU modifier? Does this get billed on the CMS-1500 along with the code for the insertion, or does it get billed as DME? Thanks for the help.

 

[dballard2004]

Any takers, please? Really need an answer to this.

 

[julieordway]

Those miscellaneous items are usually included in your CPT code and non-billable.

 

[dballard2004]

It would seem to me (and again I'm new to urology coding) that these would be reportable just like fracture care supplies.

 

[julieordway]

Under Medicare guidelines, the cost of the catheter is already built into the RVU's of the reimbursement. With that being said, you can always try billing those miscellaneous A-codes to private payors as there may be a small handful that will reimburse. We stopped billing for those a while ago since we were having to write-off way more often than collecting on. https://info.prsnetwork.com/no-billing-for-catheter-when-insertion-is-charged/

 

[dballard2004]

Under Medicare guidelines, the cost of the catheter is already built into the RVU's of the reimbursement. With that being said, you can always try billing those miscellaneous A-codes to private payors as there may be a small handful that will reimburse. We stopped billing for those a while ago since we were having to write-off way more often than collecting on. https://info.prsnetwork.com/no-billing-for-catheter-when-insertion-is-charged/

My thanks to you.