139 episodes
Urology Coding and Reimbursement Podcast Mark Painter, Scott Painter and Dr. Ray Painter
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- Health & Fitness
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.
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UCR 139: FAQs - Coding for OPTILUME, antegrade ureteroscopy code, and correct coding for torsion/orchiopexy with laterality modifiers
Available March 31, 2023
Mark, Ray, and Scott discuss FAQs:
What codes should we capture for OPTILUME? 52276 w/0499T? Or should we be looking at something else?For an antegrade ureteroscopy done via an established nephrostomy- would you recommend coding 50951 or an unlisted 53899? When coding for torsion, is the proper coding of px captured with cpt code 54600, if torsion is repaired? Laterality modifier would be appropriate if the torsion is unilateral, ie: LT or RT. Correct? If the torsion is bilateral, modifier 50 would be appropriate? After discussing with my co-workers regarding Orchiopexy 54640 versus 54600, we were a bit unsure of the term within the procedure description: Reduction of torsion of testis, surgical, ""with or without fixation of contralateral testis"". What is the correct interpretation of fixation of the contralateral side?
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UCR 138: FAQs - Interposition of peritoneal flaps code, HIPAA compliant telehealth platform PHE deadline, and coding for PVR with no bladder scan
March 24, 2023
Mark, Ray, and Scott discuss FAQs:
Would you consider interposition of peritoneal flaps separately billable with a Prostatectomy/lymphadenectomy? “The peritoneum at the dome of the bladder was folded over itself and anchored to the front sides of the bladder”. There is no guidance out there that I can find for coding, other than studies that show it is more of a prophylactic procedure to prevent lymphoceles. I am currently not coding for it but was wanting a second opinion. With the PHE ending on 5/11/2023, but telehealth being extended thru 12/31/2024, what is the ruling on using non HIPAA compliant platforms such as Facetime? Will this exception being going away with the 1135 waiver ending ?If a provider is only interested to do a post void residual (51798) and do not have a bladder scanner, can we use the ultrasound information (76857) as a post void residual and charge that way? Can you bill 76857 since the provider interprets the result of the post void residual? Thank you.
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UCR 137: When your coder and EMR disagree, what do you do?
March 17, 2023
Ray and Scott discuss a question that came into the PRS Community: When your coder and EMR disagree, what do you do?
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UCR 136: Prehab clinic coding (PT/Dietician before surgery), straight catheter billing - 51701 v P9612?
March 10, 2023
Mark, Ray, and Scott discuss questions that came into the PRS Community.
We want to do a prehab clinic for patients to improve conditions before surgery. They would be using a PT/Dietician to help improve post op complications. The reason we are contacting you is we are trying to find out the best coding scenario for this. What would you suggest regarding CPT/DX? Would we be able to do an E/M with coding such as muscle weakness etc.?We are having an issue with BCBS Medicare advantage claiming we are using 51701 inappropriately. I was not aware there were other codes for passing a straight catheter, but it was brought to our attention that we should be using P9612. Have you guys run into this before? any guidance you can offer in clarification of the use of 51701. When i was looking into this P9612 is also implying taking the urine sample from an indwelling SPT or foley, not necessarily the act of placing the disposable straight catheter in the patient to collect the sample. Have you guys seen this? what are your thoughts on 51701 vs P9612. This is my first time seeing this. Join The Urology Coding Compliance and Education Network and get started today!
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UCR 135: Crosswalk comparisons when billing unlisted codes, group visit coding
March 3, 2023
Mark, Ray, and Scott discuss questions that came into the PRS Community.
Do you have any suggestions for CPT code for the penis stuck in the foreign object /plastic bottle on penis/per op repor "tonge depressor w KY jelly placed under mouth of the botle dorsal aspect of penis, cast cutter utilized to make two adjacentcuts in mouth of bottle"
Should I bill for unlisted 55899, but what crosswalk apply?
Thank you so much!Group visits - can you bill for the time spent in a group visit with patients? Join The Urology Coding Compliance and Education Network and get started today!
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UCR 134: PCNL clarification - revisited, coding laparoscopic nephrectomy with bladder cuff, and retrograde pyelogram with stent exchanges/ureteroscopic coding
February 24, 2023
Mark, Ray, and Scott discuss questions that came into the PRS Community.
I listened to the most recent podcast episode regarding the updated PCNL codes and I'm still confused on why we can't bill 50436 or 50437 with 50080/50081? Dilation was deleted from the code description and I attended an AUA webinar in Dec 2022 that said the dilation could be reported separately. What's changed?
Good morning, Does 50548 include laparoscopic bladder cuff, or would the bladder cuff be separately billable with 51999? Bladder cuff is not mentioned in the code descriptor.
It was discussed at New Orleans seminar that retrograde pyelogram (74420) was not appropriate to report with stent exchanges/ureteroscopic procedures (as it is considered included as part of the guidance for these procedures). Is this direction based on CPT guidance or is there another reference?
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The Thriving Urology Practice Facebook Group
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Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.
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