Urology Coding and Reimbursement Podcast

著者： Mark Painter Scott Painter and Dr. Ray Painter
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  • The Urology Coding and Reimbursement Podcast is for Urologists and urology practice staff: Administrators, APPs, Billers and Coders. We help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life. Your cohosts, Mark, Scott and Dr. Ray Painter discuss urology coding and share best practices for the urology office. We will answer submitted urology coding questions so that you can learn the concepts and apply in your practice. Learn the best practices: urology coding, revenue cycle management, scheduling, collections, patient information collection, pre-authorization, prior approval, charge capture, office communications, claim entry review, appeals, audits and billing, that we have tested and proven so you can adapt and incorporate.
    © 2024 Urology Coding and Reimbursement Podcast
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  • UCR 210: stent in a pyeloplasty follow-up; G2211 and hypogonadism; and direct supervision requirements

    UCR 210: stent in a pyeloplasty follow-up; G2211 and hypogonadism; and direct supervision requirements
    2024/09/06

    September 6, 2024

    Mark, Ray, and Scott address follow-up questions from the previous episode concerning the billability of ureteral stents during procedures. They clarify distinctions between inherent procedural components and separately billable services, emphasizing the importance of documentation.

    The episode also reviews coding for G2211, where Mark adjusts his stance to include hypogonadism for long-term management. Additionally, the hosts discuss the supervision levels required for radiologic services and recommend AUACodingToday.com for efficient coding. Emphasizing up-to-date knowledge and precision in documentation, the episode closes with insights on adapting to evolving coding regulations.

    PRS Billing and Other Services - Book a Call with Mark Painter or
    Marianne Desciose

    Click Here to Get More Information and Request a Quote

    Urology Advanced Coding and Reimbursement Seminars - In-Person Seminars

    Register Now for the Urology Advanced Coding and Reimbursement Seminar

    Click Here for Information and Registration

    Event Details

    Location:
    Las Vegas: December 6-7, 2024, at Horseshoe
    New Orleans: January 31-February 1, 2025, at Harrah's

    Time: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pm

    Includes: Breakfast and Lunch on both days, plus 14 AAPC CEUs


    The Thriving Urology Practice Facebook group.

    The Thriving Urology Practice Facebook Group link to join:

    https://www.facebook.com/groups/ThrivingPractice/


    Join the discussion:

    Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

    Click Here to Start Your Free Trial of AUACodingToday.com
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    22 分
  • UCR 209: FAQ -Designated procedure room, -78; stopping a procedure prior to entering OR; and is a stent included in a pyeloplasty?

    UCR 209: FAQ -Designated procedure room, -78; stopping a procedure prior to entering OR; and is a stent included in a pyeloplasty?
    2024/08/30

    August 30, 2024

    Mark, Scott, and Ray talk about questions that came into the PRS Communities.

    1. Hi, I have a coding question pls. Thanks so much.

      Our urologist performed HIFU a month ago. Pt. had come back for Dysuria postop complication, has been having dysuria for 2 weeks. Our urologist decided to perform Cystoscopy for this.

      Cystoscopy performed, but we did Not bring Pt. back to OR. So, it should Not be a billable service
      But then, Per NCCI, Diagnostic test and procedures may be paid as a separate service during global.

      Should we bill CPT 52000? and If so, will modifier be -58, since it did not occur in OR so -78 would not be an appropriate modifier?
      Please suggest, thank you!
    2. Modifier 73 Question: Can this modifier be used when the patient is in the pre op area and he/she was given Dilaudid and another mediation and then prepped for surgery but then the patient decided they did not want to proceed because the pain medication made them feel better(Patient had a Kidney Stone). It seems resources were used and a block of time was scheduled for the facility. Wording can be a little different from our MAC, CPT, etc when some state the patient has to be taken to the operating room. Thanks for your time.
    3. Hi, We are getting some pushback and would like to know when/if ureteral stents are billable intraoperatively. Our providers are placing a stent, performing pyeloplasty in the same ureter, and the stent is routinely removed one week later.
      Is this stent placement an inherent part of performing the primary procedure, or is this a billable service? Thank you!

    PRS Billing and Other Services - Book a Call with Mark Painter or
    Marianne Desciose

    Click Here to Get More Information and Request a Quote

    Urology Advanced Coding and Reimbursement Seminars - In-Person Seminars

    Register Now for the Urology Advanced Coding and Reimbursement Seminar

    Click Here for Information and Registration

    Event Details

    Location:
    Las Vegas: December 6-7, 2024, at Horseshoe
    New Orleans: January 31-February 1, 2025, at Harrah's

    Time: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pm

    Includes: Breakfast and Lunch on both days, plus 14 AAPC CEUs


    The Thriving Urology Practice Facebook group.

    The Thriving Urology Practice Facebook Group link to join:

    https://www.facebook.com/groups/ThrivingPractice/


    Join the discussion:

    Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.



    Click Here to Start Your Free Trial of AUACodingToday.com
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    28 分
  • UCR 208: FAQ - Clot evacuation and fulguration coding; robotic assisted partial nephrectomy and lymph node resection: clarification

    UCR 208: FAQ - Clot evacuation and fulguration coding; robotic assisted partial nephrectomy and lymph node resection: clarification
    2024/08/22

    August 23, 2024

    Mark, Scott, and Ray talk about two questions that came into the PRS Communities:

    1. I have Optum requesting records on all of our clot evac cases where something in the bladder was fulgurated during the same session and after record review we fail the audit.
      Now compliance is very quick to say refund it, stop billing it, its bundled, etc.
      But we know a modifier is allowed so when is it allowed????
    2. Everything I find online like AAPC says to bill both 52214 and 52001-59 but there is nothing recent and nothing concrete about what is considered distinct. I mean using a clot evacuator is different than using a loop electrode. Below are the Optum rationales.
      So the urologist does a cysto on hematuria work up, and they wind up using an evacuator to remove huge amounts of clot burden. Then use a loop electrode to fulgurate some areas that look suspicious.
      Why is that service not considered distinct? Compliance says its incidental but they can't tell me when it wouldn't be incidental and I don't want to let optum take back money without an argument.
    3. Hi, I would like to ask a coding question please. Thank you so much!
    4. For Robot-assisted left partial nephrectomy and Resection of a left renal hilar lymph node, Do we code any additional CPT to capture renal hilar lymph node, in addition to partial nephrectomy 50543?
    5. Pathology report had a separate report for Renal hilar lymph node dissection, which was negative for carcinoma. And for partial nephrectomy, path showed Renal cell carcinoma.

    PRS Billing and Other Services - Book a Call with Mark Painter or
    Marianne Desciose

    Click Here to Get More Information and Request a Quote

    Urology Advanced Coding and Reimbursement Seminars - In-Person Seminars

    Register Now for the Urology Advanced Coding and Reimbursement Seminar

    Special Early Bird code: 25UACRS732

    Click Here for Information and Registration

    Event Details

    Location:
    Las Vegas: December 6-7, 2024, at Horseshoe
    New Orleans: January 31-February 1, 2025, at Harrah's

    Time: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pm

    Includes: Breakfast and Lunch on both days, plus 14 AAPC CEUs


    The Thriving Urology Practice Facebook group.

    The Thriving Urology Practice Facebook Group link to join:

    https://www.facebook.com/groups/ThrivingPractice/


    Join the discussion:

    Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.

    Click Here to Start Your Free Trial of AUACodingToday.com
    続きを読む 一部表示
    19 分

あらすじ・解説

The Urology Coding and Reimbursement Podcast is for Urologists and urology practice staff: Administrators, APPs, Billers and Coders. We help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life. Your cohosts, Mark, Scott and Dr. Ray Painter discuss urology coding and share best practices for the urology office. We will answer submitted urology coding questions so that you can learn the concepts and apply in your practice. Learn the best practices: urology coding, revenue cycle management, scheduling, collections, patient information collection, pre-authorization, prior approval, charge capture, office communications, claim entry review, appeals, audits and billing, that we have tested and proven so you can adapt and incorporate.
© 2024 Urology Coding and Reimbursement Podcast
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