April 19, 2024Ray, Mark, and Scott discuss the nuances of communicating with payers and clearinghouses during the post-operative global period.  New Courses Available for Urologists and Urology APPsDocumentation for Reimbursement Challenge for Urologists​ Use Special Discount Code:DRC5624 and Save 36% ​Documentation for Coding and Reimbursement for APPs​ Use Special Discount Code: DCRA5624 and Save 36%Certification for Urology CodersDocumentation, Coding, and Billing Certification Course for Urology CodersUse Special Discount Code: DCBSC5624 and Save 36%PRS Billing and Other ServicesClick Here to Get More Information and Request a Quote   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

April 12, 2024Mark and Scott discuss questions that have come into the PRS communities:Hi is there any documentation, regarding the age limit for G2211 or 99459?Our MD think that they only apply to patients over 65 years old.  Is this true or is there documentation stating we can use them on patients under 65 years old.  If a patient fails a Trial of void, and a catheter is placed, would the 51700 be coded or just 51702? Should it matter if pass its fail? The service was still performed. And the 51702 is a component of the 51700.What are the codes that I use for gemcitibine bladder installation in the office. I know I would use 51720 would be the cpt code but how do i bill for the medicine?For Scrotoplasty, complicated (CPT 55180), Does it need to be performed with either Graft of Flap, to call for "complicated"? I am trying to differentiate between 55175 (scrotoplasty, simple) and 55180 (scrotoplasty, complicated), thank you! New Courses Available for Urologists and Urology APPsDocumentation for Reimbursement Challenge for Urologists​ Use Special Discount Code:DRC5624 and Save 36% ​Documentation for Coding and Reimbursement for APPs​ Use Special Discount Code: DCRA5624 and Save 36%Certification for Urology CodersDocumentation, Coding, and Billing Certification Course for Urology CodersUse Special Discount Code: DCBSC5624 and Save 36%PRS Billing and Other ServicesClick Here to Get More Information and Request a Quote   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

April 5, 2024Mark, Scott, and Ray discuss why PRS developed two new courses, one for Urologists and one for APPs These courses aim to tackle the challenges practices face with documentation for reimbursement and efficient use of Electronic Health Records (EHR), emphasizing the importance of a unified team approach to stay updated on coding, billing, and documentation. They also discuss the critical role of Advanced Practice Providers (APPs) in urology, their billing nuances, and the necessity of continuous education to ensure financial health and combat provider burnout. The discussion wraps up with insights into the evolving landscape of medical coding and billing, stressing on AI's role in audits and the need for precise documentation. Links to further details about the courses can be found below. New Courses AvailableDocumentation for Reimbursement Challenge for Urologists​ Use Special Discount Code: DRC5624 and Save 36%  (ends 5/6/24) ​Documentation for Coding and Reimbursement for APPs​ Use Special Discount Code: DCRA5624 and Save 36%  (ends 5/6/24)Certification for Urology CodersDocumentation, Coding, and Billing Certification Course for Urology CodersUse Special Discount Code: DCBSC5624 and Save 36%  (ends 5/6/24)PRS Billing and Other ServicesClick Here to Get More Information and Request a Quote   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

March 28, 2024Mark, Scott, and Ray welcome Dr. David J. Ellis to discuss the evolution of urology practice, leadership strategies, the role of organizations like LUGPA, AUA, and AACU, and the importance of communication and education in the field.PRS Billing and Other ServicesClick Here to Get More Information and Request a Quote   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

March 22, 2024Mark, Scott, and Ray discuss the Change Health cyberattack, G2211 developments and questions that came into the PRS Network.We have been receiving denials for our Urodynamics appointments because authorization was obtained under a provider that differs from the provider that signed off on the note day of services. For non-medicare plans (and plans that do not adhere to 100% of medicare guidelines) are we able to have a provider that is not on-site at the time of the UDS appointment sign off on the note?We are a multi-specialty practice that all share one TIN. If we send an established patient to be seen by a provider that practices under a different taxonomy, can this provider then bill under a new patient encounter? For example, Urology refered to Urogynecology or if Oncology referred to Urology? Additionally, can these pts be seen by differing specialties, at different office locations on the same day?   PRS Billing and Other ServicesClick Here to Get More Information and Request a Quote   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

March 15, 2024Mark, Scott, and Ray discuss questions that came into the PRS Network.Hello,What is the recommendation on documentation for new code 99459? Our practice is wanting to create a template for this procedure code. I know documenting a chaperon is key. Thank youHello,I need help.I am having issues with multiple insurance companies denying diagnosis code N30.10 stating it is an invalid code. Anyone else experiencing this issue? Any indication on what the issue is?I looked in the ICD10 code book and it states it is a billable code.Thank youHi I have a coding question for peds urology.Can CPT 51701 be used for a urine capture for UAs? Since this is peds our payor mix does not include medicare. I was under the impression that for commerical payors 51701 cannot be used for urine capture and that it would bundle into the E/M service.Also, shouldn't we be able to code 81001-81003 for the UA? The provider is only coding an E/M service with 51701.Thanks!  PRS Billing and Other ServicesClick Here to Get More Information and Request a Quote   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

March 8, 2024Mark, Scott, and Ray discuss questions that came into the PRS Network.Hello all, I have a CPT coding question,Indications = Urinary Obstruction // Post-Op DX = Obstruction of neck of Urinary Bladder Resectoscope per urethra into the bladder under direct vision. There was moderate trabeculations with no evidence of mass or stones. The bladder neck was noted to be elevated as seen on prior clinic cystoscopy. This was causing obstruction of the bladder outlet without significant prostatic hypertrophy.The bipolar resectoscope was used with the plasma button attachment to perform a TUIP at 5 o'clock, vaporizing the bladder neck fibers until the bladder neck was able to open properly and drain appropriately. Electrocautery was used for any small bleeding vessels and hemostasis was adequate at the end of the procedure.The recommended Code is: 52450, but the Coder is recommending Code: 52500.We're also taking Codes: 52276 & 52214 into consideration.... Please advise on what you recommend with the Rationale. Any assistance is greatly appreciated.I completed a  tapered ureteral reimplant  50783 on the left and a standard Non tapered ureteral reimplant on the right 50780 - does adding LT and RT modifiers allow both codes to be billed as follows:50783 LT50780.51.RT  does adding R /L mods  address the bundling issue?Coders noting that 50783 includes 50780 -- however this is  2 different sides and can't bill bilateral tapered 50783.50, as only tapered one side, and bilateral reimplant 50780.50 is undercoded for the additional time and complexity of ureteral tapering Has anyone billed for bladder injection of Lipiodol before? I have a provider who resected a large bladder tumor, then injected Lipidol in and around the resection site to aid with the patient's radiation planning for invasive bladder cancer. I was thinking this may be included in the 52240, but the office is suggesting unlisted code 53899 benchmarked to 52287 or 52283. Thoughts? Registration is open for the Documentation for Coding and Reimbursement for APPs Course - Starts 3/11/24Click Here for Information and to JoinPRS Billing and Other ServicesClick Here to Get More Information and Request a Quote   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

March 1, 2024Hosts Scott, Mark, and Ray discuss the upcoming MIPS submission deadline of April 1st and address common questions about MIPS submissions. Registration is open for the Documentation for Coding and Reimbursement for APPs Course - Starts 3/11/24Click Here for Information and to JoinPRS Billing and Other ServicesClick Here to Get More Information and Request a Quote   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

February 23, 2024Mark, Scott, and Ray discuss questions that came into the PRS Network: Regarding the most recent podcast episode on shard/split visits: Medicare's policy states that only one practitioner must have face-to-face time with the patient. In our practice the physician documents an addendum on the APP's note with the medical decision making portion of the visit. Per the episode, the physician must demonstrate involvement during the visit (not afterwards) in order to bill under the physician's NPI. Is there a guideline that states the physician must document their portion in real-time as the visit with the APP takes place? If they document the MDM portion of the visit in its entirety, isn't that enough to bill for the "substantive portion of MDM" as required by Medicare?For 52001, we commonly use this code for cysto and clot evacuation for gross hematuria under general anesthesia requiring rigid scope. Are physicians allowed to use this code for cystoscopy and irrigation of a clot with a syringe under local procedure or should they use 52000 + 57000?For 52281, does passage of the cystoscopy to dilate a narrowing in the urethra or meatus count? Or it is only meant to be used for cases where the meatus is cut or dilators or DVIU are used? Join the Documentation for Reimbursement Challenge - Starts 2/26/24Click Here for Information and to JoinPRS Billing and Other Services Click Here to Get More Information and Request a QuoteThe 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

February 16, 2024Ray and Scott discuss the importance of documentation for reimbursement.They emphasize the need to communicate effectively through documentation with billers, computers, and AI systems to ensure accurate coding and payment for services provided. They also mention the significance of using the right words in documentation to justify the level of service, multiple procedures, and modifier usage in order to obtain appropriate reimbursement. Additionally, they talk about the upcoming "Documentation for Reimbursement Challenge" that aims to help urologists and APPs improve their documentation skills for maximum reimbursement. Join the Documentation for Reimbursement Challenge - Starts 2/26/24Click Here for Information and to JoinPRS Billing and Other Services Click Here to Get More Information and Request a QuoteThe 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

February 9, 2024Ray, Mark, and Scott discuss questions that came in about split or shared Visits.Our questions are: When our doctors cover hospital patients, we often have Physician Assistants in the hospital rounding on new and follow up patients. Recently there is an Incident-to policy change, but I don’t think that applies to the hospital PAs since hospital charges cannot be billed incident-to. Regardless, what do you think of the following:Are our physicians able to bill for those visits at 100 percent?If yes, could they still bill via supervisory role to the PAs (i.e., the PA see the patient and discuss the patient’s case with the on call physician. The physician then formulates a follow up plan and communicate it directly to the PA without physically seeing the patient)? Or do the physicians have to physically see the patient to be able to bill?Are physicians able to bill for procedures done by the PAs at the hospital?Thank you so much for your assistance and guidance on this matter. G2211 Guidance Document [free download]Click Here for the Link to Download the Guidance Document PRS Billing and Other Services Click Here to Get More Information and Request a QuoteThe 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

February 2, 2024Ray, Mark, and Scott answer and discuss the following questions:The seminar this past week was great. I have one question that I asked during the seminar but still not sure of the correct answer. For an initial hospital consultation, I have been using 99223 and generally 99232 for follow up visits. Is this correct.Seeking clarification for the best way to code:Ureteroneocystostomy; anastomosis of single ureter to bladder with vesico-psoas hitch--Robotic approachis it an unlisted code or 50948? Thank you in advance :)I've received several questions recently on whether or not certain procedures can be performed in office by an APP alone (51720, 95972, Eligard/Firmagon injections etc.). Most codes as long as they are not surgical can be performed by an APP since they are a qualified healthcare provider, correct? Not sure where I can find info on this. I did check state statutes but found nothing specific about which procedures. Thanks!If a patient comes in for routine SPT change or lupron injection, and provider states return in a week or month for next change or injection, is that enough for a modifier -25 to billed?For the 99459 we have a gynurologist she does pelvic exams on almost all her patients unsupervised can we still add this code to her visits? Thank you G2211 Guidance Document [free download]Click Here for the Link to Download the Guidance Document PRS Billing  Click Here to Get More Information and Request a QuoteThe 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

January 19, 2024Scott and Mark discuss the topics of G2211 and code 99459. They clarify some common questions and confusion surrounding these codes, provide guidance on their appropriate use, and share updates on their experience with Medicare, Medicare Advantage plans, and private payers. They also talk about code 99459 and the importance of documenting the presence or absence of a chaperone during a female pelvic exam. G2211 Guidance Document [free download]Click Here for the Link to Download the Guidance Document ___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

January 12, 2024Scott and Dr. Ray Painter discuss the top issues impacting urologists and their practices. G2211 Guidance Document [free download]Click Here for the Link to Download the Guidance Document Urology Advanced Coding and Reimbursement Seminar(Click Here for More information and Registration) New Orleans, January 26 & 27, 20248 am - 4:30 pm Friday, 8 am - 3:30 pm SaturdayReserve your spot and save! Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.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

January 5, 2024Mark, Scott, and Dr. Ray Painter discuss the new G2211 code.  How it should be used, examples, provide scenarios, and share questions about using the code. G2211 Guidance DocumentClick Here to get free Download Link  (available January 8th, 2024)Urology Advanced Coding and Reimbursement Seminar(Click Here for More information and Registration) New Orleans, January 26 & 27, 20248 am - 4:30 pm Friday, 8 am - 3:30 pm SaturdayReserve your spot and save! Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.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© 2024 Physician Reimbursement Systems, Inc.Home

December 29, 2023Mark, Scott, and Dr. Lin discuss topics from the Thriving Urology Practice Facebook Group:There is still no CPT code for extricating the penis from a foreign body, right?Guy used a 2.5 pound weight plate as a penis ring. Took an ortho saw to remove it.Medtronic Midas Rex handheld device with a circular Diamond bit saw was used to cut the plate at 3 and9 o’clock positions. 2 separate Medtronic Midas Rex devices had to be used due to heat generation.Complete transection of the plate was performed. Penis was protected from the heat and the blade toeffect a successful extrication.How do we bridge the gap between those urologists and APPs who are practicinghappily and getting paid for everything they do, not spinning their wheels, not burningout, vs. those who continue to suffer? Urology Advanced Coding and Reimbursement Seminar(Click Here for More Information and Registration) New Orleans, January 26 & 27, 20248 am - 4:30 pm Friday, 8 am - 3:30 pm SaturdayReserve your spot and save! Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.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, ask your questions, and share your wisdom.Click Here to Start Your Free Trial of AUACodingToday.com

December 22, 2023Mark, Ray, and Scott answer questions from the PRS Urology Coding Community:I have multiple providers who want to bill 55867 & 51860 for the same procedure. While there’s isn’t an NCCI Edit for these codes, you can see that the procedure description includes both the making of an incision in the bladder wall and then later the suture repair. Coding guidelines dictate that since you could not perform the main surgical procedure without the minor one, then the minor is bundled into the major. As a coder I don't feel that there is support for separate reimbursement when the two codes are routinely billed together. Their contention is that there are 2 ways to do a simple prostatectomy. The first is through the capsule of the prostate gland without a bladder incision. The simple prostatectomy code has traditionally encompassed the first way of not making a bladder incision and if an incision was made then a cystorrhaphy was billed. With the addition of the new code specifically for the simple prostatectomy, I would like some direction on how these codes should be billed.Have you been able to lookup what the reimbursement will be for the new CPT code 99459 for female pelvic exam?Can 51741 and/or 51798 be billed twice on the same day?For example, if a patient does the first urofow and the volume is not adequate and then we have him drink and come back later for a second uroflow. When billing 51700 for voiding trial post-op after prostatectomy (90 day global), is a modifier needed ? Such as modifier 58 Urology Advanced Coding and Reimbursement Seminar(Click Here for More information and Registration) New Orleans, January 26 & 27, 20248 am - 4:30 pm Friday, 8 am - 3:30 pm SaturdayReserve your spot and save! Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.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

December 15, 2023Mark, Ray, and Scott welcome Dr. Richard Pelman to discuss the importance of State Urology Societies and why you should participate. Urology Advanced Coding and Reimbursement Seminar(Click Here for More information and Registration) New Orleans, January 26 & 27, 20248 am - 4:30 pm Friday, 8 am - 3:30 pm SaturdayReserve your spot and save! Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.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

December 8, 2023Mark, Ray, and Scott welcome Dr. John Lin to discuss the 2024 Urology Coding and Reimbursement Seminar and share their thoughts about the 2024 Urology Coding and Reimbursement Seminar in Las Vegas, on December 1st and 2nd, 2023. Urology Advanced Coding and Reimbursement Seminar(Click Here for More Information and Registration) New Orleans, January 26 & 27, 20248 am - 4:30 pm Friday, 8 am - 3:30 pm SaturdayReserve your spot and save! Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.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

December 1, 2023Mark, Ray, and Scott welcome Dr. Jonathan Rubenstein to discuss the big CMS changes for urology in 2024 and how to implement them. Urology Advanced Coding and Reimbursement Seminar(Click Here for More information and Registration) New Orleans, January 26 & 27, 20248 am - 4:30 pm Friday, 8 am - 3:30 pm SaturdayReserve your spot and save! Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.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