Urology Coding and Reimbursement Podcast

Mark Painter, Scott Painter and Dr. Ray Painter

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.

  1. 2天前

    UCR 259: Bladder Cancer Reimbursement Strategies – Using Unlisted J Codes and the New Zusduri Hub Tools

    UCR 259: Bladder Cancer Reimbursement Strategies – Using Unlisted J Codes and the New Zusduri Hub Tools September 19, 2025  In this episode, Scott, Mark, and Ray Painter dive into bladder cancer reimbursement with a special focus on billing strategies for new intravesical therapies like Zusduri, which currently lack established J codes. Mark outlines the complete reimbursement pathway from diagnosis coding through installation documentation, prior authorizations, appeals, and follow-up. They discuss the importance of accurate diagnosis flow, clear drug documentation, and the nuances of billing unlisted codes—including Box 19 tips and JW modifiers. The episode also introduces PRS Network’s new Zusduri Reimbursement Hub, including a custom J Code calculator designed to help practices manage invoicing timelines, track payment cycles, and streamline claim submissions. This tool is a game-changer for practices adopting new therapies. The Painters wrap up with reflections on the importance of payer education, the role of pioneers in improving access to innovative urology treatments, and how this supports better outcomes for patients. Urology Advanced Coding and Reimbursement Seminar Information and Registration PRS Coding and Reimbursement Hub Access the Hub Free Kidney Stone Coding Calculator Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins PRS Billing and Other Services - Book a Call with Mark Painter or  Marianne Desciose Click Here to Get More Information and Request a Quote   Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.          https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com    The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/

    26 分钟

  2. 3天前

    UCR 258: Telehealth in Limbo — What’s Next as the Deadline Looms?

    September 17, 2025  In this episode, Scott, Mark, and Ray Painter break down the latest updates on the future of Medicare telehealth coverage as the September 30, 2025, deadline approaches. Mark shares insights into recent bipartisan efforts in Congress, including a proposed stopgap measure to extend current telehealth rules through November. They also discuss the political tug-of-war surrounding ACA tax credits and how the budget debate could impact telehealth services. Tune in to understand what this means for your practice, how to handle telehealth scheduling in October, and what documentation is needed if coverage lapses. Plus, final thoughts on why this remains a political football despite broad support for continuing telehealth. Urology Advanced Coding and Reimbursement Seminar Information and Registration PRS Coding and Reimbursement Hub Access the Hub Free Kidney Stone Coding Calculator Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins PRS Billing and Other Services - Book a Call with Mark Painter or  Marianne Desciose Click Here to Get More Information and Request a Quote   Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.          https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com    The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/

    17 分钟

  3. 9月4日

    UCR 257: Clearing the Field — Catheters That Suck and Understanding C9761

    September 5, 2025  In this episode, Scott, Mark, Ray, and special guest Dr. John Lin delve into the nuances of coding and billing for steerable vacuum-assisted catheters used in large stone removal. They clarify the differences between DISS (Direct In-Scope Suction) and FANS (Flexible and Navigable Sheaths), explain the use of HCPCS code C9761, and discuss what it means for facilities, surgery centers, and urologists. Urology Advanced Coding and Reimbursement Seminar Information and Registration PRS Coding and Reimbursement Hub Access the Hub Free Kidney Stone Coding Calculator Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins PRS Billing and Other Services - Book a Call with Mark Painter or  Marianne Desciose Click Here to Get More Information and Request a Quote   Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.          https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com    The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/

    38 分钟

  4. 9月4日

    UCR 255: Medicare’s WISeR Program – Prior Auth Comes to Traditional Medicare and Facility Payments for Catheters That Suck

    August 15, 2025  In this episode, Scott, Mark, Ray, and special guest Dr. John Lin dive deep into Medicare’s upcoming Wiser Program—set to begin in 2026—which brings prior authorization to traditional Medicare for select urology services. Learn which states are impacted, what procedures are targeted, and what steps urologists need to take to prepare. The team also discusses the growing use of steerable ureteral catheters and how facilities can (or can’t) use code C9761 for reimbursement. Get practical advice on documentation, appeal strategies, and how to advocate for your practice in this evolving regulatory landscape. NCDs Sacral Modulation NCD Incontinence NCD Impotence NCD PRS Coding and Reimbursement Hub Access the Hub Free Kidney Stone Coding Calculator Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins PRS Billing and Other Services - Book a Call with Mark Painter or  Marianne Desciose Click Here to Get More Information and Request a Quote   Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.          https://www.prsnetwork.com/joinuptp

    43 分钟

  5. 8月22日

    UCR 256: A Hybrid Urology Practice—Dr. Marc Rose’s Concierge Model Journey

    August 22, 2025  In this special episode, Scott, Mark, and Ray welcome Dr. Marc Rose, a practicing urologist in Vero Beach, Florida, to share his journey of transitioning to a hybrid urology practice that combines traditional insurance with concierge medicine. Dr. Rose walks us through the burnout that led him to make a change, how he structured his new model, and the lessons he’s learned since making the leap. He explains how the practice operates day-to-day, how patients respond to concierge options, and the role his nurse practitioner and support team play. Whether you’re a urologist exploring alternative practice models or just curious about the benefits and challenges of concierge care, this episode offers valuable firsthand insight. Contact Dr. Marc Rose concierge@marcroseurology.com   PRS Coding and Reimbursement Hub Access the Hub Free Kidney Stone Coding Calculator Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins PRS Billing and Other Services - Book a Call with Mark Painter or  Marianne Desciose Click Here to Get More Information and Request a Quote   Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.          https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com    The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/

    29 分钟

  6. 8月8日

    UCR 254: Downcoding on the Rise – What to Watch For, and is United Healthcare getting out of Medicare Advantage plans?

    August 8, 2025  In this episode, Scott, Mark, and Ray discuss the troubling expansion of automatic E/M downcoding by payers—and what your practice can do about it. Mark explains which payers are leading this trend, how to identify if your claims are being affected, and practical steps to reverse these denials and protect revenue. Then, the team unpacks the recent news about UnitedHealthcare dropping certain Medicare Advantage plans, what it really means, and how to prepare your front desk and billing staff for potential patient coverage changes. Stay informed, stay proactive! PRS Coding and Reimbursement Hub Access the Hub Free Kidney Stone Coding Calculator Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins PRS Billing and Other Services - Book a Call with Mark Painter or  Marianne Desciose Click Here to Get More Information and Request a Quote   Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.          https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com    The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/

    26 分钟

  7. 8月1日

    UCR 253: Complex Bladder Clot Evacuation Coding and How to Bill Pre-Surgical E/M Services

    August 1, 2025  In this episode, Scott, Mark, and Ray answer coding questions submitted through the PRS Helpdesk.  Pay er: Anthem BCBS State: NV Code/Codes: Tranurethral resection of bladder clot that was organized to facilitate removal Catagory: OtherQuestion: I'm looking for a CPT code for : transurethral resection of bladder clot that was organized t facilitate removal Pt was inpt and Dr tried to do a clot removal from the bladder, but was unsuccessful as the whole bladder was the clot. So he used a resectoscope to resect the clot into smaller pieces and then removed them with a ridid biopsy forceps. This procedure took over 2 hours. I need help with a CPT code that will accurately describe this procedurePayer: N/A State: TX Code/Codes: N/A Catagory: OtherQuestion: Do you have info or prior podcast on billing for updated h/p prior to surgery if prior h/p done greater than 30 days before surgery? Appreciate help or directions to podcast if available. Sincerely, Irene McAleer, MD,JD,MBA immmac@msn.com 948-610-9449 Sent from my iPhonePayer: Mix State: Ohio Code/Codes: 57 vs. 25 modifier Catagory: OtherQuestion: When is best to use 25 vs. 57 same day procedure/OR - I thought anything requiring anesthesia would be OR procedure? Cysto/stent, cysto clot evaluation, etc would be 57 but is 25 more appropriate even if done in the OR? PRS Coding and Reimbursement Hub Access the Hub Free Kidney Stone Coding Calculator Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins PRS Billing and Other Services - Book a Call with Mark Painter or  Marianne Desciose Click Here to Get More Information and Request a Quote   Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.          https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com    The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/  © 2025 Physician Reimbursement Systems, Inc.

    25 分钟

  8. 7月25日

    UCR 252: Documentation and Coding for - Aborted Stone Procedure, Urethral Pressure Studies, Prostate Biopsy Guidance, and Fiducial Marker Placement

    July 25, 2025  In this episode, Scott, Mark, and Ray answer coding questions submitted through the PRS Help Desk.  1) Payor: Medicare State: FL Code/Codes: 52353-52 and 52332-59-51 Catagory: Kidney Stones Question: If I have to abort a planned ureteroscopy and laser lithotripsy because the UO is too narrow to pass the ureteroscope so I place a stent. Can I bill the 52353-52 and 52332-59-51 2) Can you clarify what documentation is required to be able to code 51729? Is the length of the urethra required to be documented or is it just a possible element? The AUA policy & Advocacy brief for Urodynamcis shows the example documentation of the UPP as, “ Urethreal Pressue Profile: The maximum urethral pressue profile was 45 cm of water with a functional urethral lenght of 2.75 cm. At 200cc, coughing was iniitated. There was no demonstrable leak of urine at 117 cm of water with abdominal straining.” My provider is only documenting: Leak point pressure testing: volume tested: 150mL, Stress Induced DO: Absent Valsalva Leak Point Pressure: No Leak. Is that enough to capture 51729? Thank you for your assistance!   3) Can you tell me the best way to document and correctly bill for prostate biopsy using 55700/76942 and 76872?  I am told we are no longer getting paid for those. 4) What is the best way to document and code for placement of fiduciary markers under US guidance? Thanks in advance PRS Coding and Reimbursement Hub Access the Hub   Free Kidney Stone Coding Calculator Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins PRS Billing and Other Services - Book a Call with Mark Painter or  Marianne Desciose Click Here to Get More Information and Request a Quote   Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner. https://www.prsnetwork.com/joinuptp   Click Here to Start Your Free Trial of AUACodingToday.com    The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/

    30 分钟
查看全部 258 集

评分及评论

4.8
共 5 分
14 个评分

关于

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.

信息

  • 创作者
    Mark Painter, Scott Painter and Dr. Ray Painter
  • 活跃年份
    2020年 - 2025年
  • 单集
    258
  • 分级
    儿童适宜
  • 版权
    © 2025 Urology Coding and Reimbursement Podcast
  • 节目网站
    Urology Coding and Reimbursement Podcast

你可能还喜欢