Urology Coding and Reimbursement Podcast

March 26, 2021 Mark, Ray, and Scott discuss a problem with United Health Care and payment delays for higher-priced claims (ie Provenge, Urolift).  What options do you have? What should you do? Share your payer stories with us Email:  info@prsnetwork.com or on the free Q&A forum Urology Coding and Reimbursement Group . Take the 30 Day Urology Coding and Billing Challenge and learn what a coder,...

March 19, 2021 Mark, Ray, and Scott discuss several questions about the new 2021 E&M rules from the Urology Coding and Reimbursement Group: Question 1 (:55) For bilateral Ureteroscopy Laser lithotripsy with stent placements can we bill 52353, 52332 (using N20.0 as diagnosis) & 52356 (using N20.1 as diagnosis) Question 2 (5:35) For Urodynamics- when patient has foley catheter in place prior...

March 12, 2021 Ray, Mark and Scott discuss technical revisions that the AMA released March 9th, 2021.  The team breaks down what's different and what urology practices need to understand.   In addition to the details, they will also give urology examples so you understand the concepts. Link to the CPT® Evaluation and Management (E/M) Office or Other Outpatient (99202-99215) and Prolonged Serv...

March 7, 2021 Ray, Mark, and Scott discuss deductibles and the impact they have on urology practices.  The importance of previsit planning and training to ensure a healthy practice. Take the 30 Day Urology Coding and Billing Challenge and learn what a coder, biller, admin, and other non-QHPs should know and nothing more. Learn More Join the discussion: Urology Coding and Reimbursement Group - Join...

UCR 040: "Incident to" billing; When to bill the 99211- Nurse Visit February 26, 2021 Ray, Mark and Scott discuss incident to billing and when to bill the 99211 nurse visit.     Take the 30 Day Urology Coding Challenge and learn what a QHP should know and nothing more. Learn More Join the discussion: Urology Coding and Reimbursement Group - Join for free and ask your questions, and share...

February 19, 2021 Ray, Mark and Scott discuss questions from the Urology Coding and Reimbursement Group   Question 1:  40 Seconds Hello,  one of our physicians has been doing multiple ESWL's (cpt 50590) on the same dos for treating more than one stone..i.e one kidney stone, one ureteral stone or bilateral stones..i have found info that says only one 50590 per dos and also to unbundle with an...

February 16, 2021 Ray and Scott discuss what a urology QHP should do and what they should not do.  As we teach at PRS, you should always work at the top of your license.  This does include some coding and billing.  Ray and Scott discuss and give some examples of the role the QHPs. Take the 30 Day Urology Coding Challenge and learn what a QHP should know and nothing more. Learn More Join the discus...

February 5, 2021 Mark, Ray, and Scott discuss Risk under the new E&M 2021 guidelines.  Mark lays out a position that you can have a level 2, 3, 4, and 5 for watchful waiting for patients with prostate cancer.  Your documentation is the key.  You need to provide the complete picture to include clinical and medical reimbursement perspectives. Take the 30 Day "Code like Mark Painter" Ch...

UCR 036: Why Modifier -25 is so important and how it works with the EM 2021 Rules January 29, 2021 Mark, Ray, and Scott discuss Modifier -25 and how it fits in with the new E&M 2021 Rules.  They discuss why Modifier -25 continues to be so important and give examples of what changes with the new guidelines.  You can save time by knowing the rules and how to use new guidelines.    Your defensibl...

UCR 035: E&M 2021 Q&A: Other qualified health professional definition, Data - can I count note and PSAs in the note as separate data points? Is BCG with assessment a level 2 E/M? Prescription drug management clarification. January 15, 2021 Mark, Ray, and Scott discuss several questions about the new 2021 E&M rules from the Urology Coding and Reimbursement Group: Question 1 It's no...

UCR 034: 2021 last-minute changes, G2211 update, MRI fusion biopsy of prostate coding, and initial vs subsequent dilations January 8, 2020 Mark, Ray, and Scott talk about the last-minute changes-  Congress passed a Covid Relief package that included a few impactful changes. They also, discuss the changes with the new code G2211 which now cannot be Paid until 2024. Finally, they answer 2 questions...

Mark, Ray, and Scott talk about lessons learned from the first 33 episodes.  Also, they answer the question "what do you see as the biggest challenge (or opportunity) coming in 2021"?  Lastly, they discuss where the podcast is headed in the future. Urology Advanced Coding and Reimbursement Seminar - Virtual Live Event January 29th and 30th, 2021 10am - 6pm EST each day Learn More Join th...

Part 2 of 2 - The final Medicare rule was published on 12/2/2020.  Mark presents what has changed, what is important, and the impacts the new rules are going to have on your practice.  He also points out what you need to do to prepare your practice. Last Chance to Learn the New E&M Rules in 2020 Live Workshop December 21st, 2020 7pm - 10pm EST Learn More Join the discussion: Urology Coding and...

Part 1 of 2 - The final Medicare rule was published on 12/2/2020.  Mark presents what has changed, what is important, and the impacts the new rules are going to have on your practice.  He also points out what you need to do to prepare your practice. Last Chance to Learn the New E&M Rules in 2020 Live Workshop December 21st, 2020 7pm - 10pm EST Learn More Join the discussion: Urology Coding and...

November 24, 2020 Happy Thanksgiving! Mark, Ray, and Scott discuss the Urology Advanced Coding and Reimbursement Seminar Agenda.  Mark explains what we have included and why.  Ray emphasizes that there are a lot of big changes this year that can lead to positive outcomes for urology practices. Here is the Agenda for the Upcoming Virtual Live Event:   Friday 12/4/20 Time (EST)         |   Topic 10:...

November 17, 2020 Mark, Ray, and Scott discuss the 2nd wave of the pandemic and what that means to the urology practice.  The first wave was dedicated to figuring out how to deal with the shutdowns/slowdowns and telehealth.  This next wave, if there is a slowdown there are some opportunities to use that time to streamline your practice.  Given the new Zoom skills we have all developed, there are o...

Mark, Ray, and Scott talk with Larry Kemp, FACHE about assessing your business practices, digging deep to identify the core problem, developing a road map, and then solving the root of the problem.  Larry points out that " Being Paid is Not the Same as Paid Accurately".  You have to make sure you efficient in the things you can control in your practice.  It is hard to extract more income...

Mark, Ray, and Scott discuss some lessons and nuances that they learned during the discussion at the recent E&M 2021 workshops.  Mark shares the reasoning behind a vasectomy consult and what level it will probably fall with the new guidelines.  Also, he discusses the question - will all prostate cancer E&M visits be a level 4? Ray shares why the new guidelines are going "back to the f...

Mark gives an update on the status of the Public Health Emergency (PHE). Mark, Ray, and Scott discuss FAQs: Coding for a stent removal using a snare without radiologic guidance. CPT code is for the i-Tind procedure Can you code a consultation visit (non Medicare) for new patient office visit seen in the ER Additional clarification on the 25 modifier. Urology Advanced Coding and Reimbursement Semin...

Scott and Ray discuss the Urology Advanced Coding and Reimbursement Seminar.  Ray shares how it all began and why. They discuss how the Urology Advanced Coding Seminar is going to be different this year.   Not only is it going to be a live virtual event but have added additional products and services to help practices prepare for 2021.

Mark, Ray, and Scott answer questions from the Urology Coding and Reimbursement group. Mark gives  1)  Can urologist bill for Covid intake screenings? We hear from a  provider that when  patient walks in the door and we perform the  Covid intake screening ( we do these anyways), we can bill for this? We would have to submit out Covid form, a medical form, and a SOAP note, these can be signed by an...

Mark, Ray, and Scott discuss the new ICD-10 codes that go into effect 10/1/20.  Make sure your Electronic Health Record and Practice Management System are up to date with the new codes.  Luckily there are not that many new codes and will not have a big impact on most urology practices. Download a copy of the ICD-10 additions and changes here: Urology ICD-10 Changes Effective 10-1-2020.pdf Get a co...

September 18, 2020 Scott shares the 3 simple steps PRS uses to create the PRS education projects. We have, over the last 30 years, developed a system for creating education products. We used this tested and proven method to develop the upcoming E&M 2021 Live Online Workshop. Upcoming E&M 2021 Live Online Workshops Learn More Dates (all times Eastern) September 18, 2020 - 5:00 pm  September...

Mark provides an overview of Telehealth utility now and post Public Health Emergency.  He shares 3 opportunities to explore using Telehealth, if you are not doing so already. 1.) Basic Telehealth - Synchronous Audio Visual 2.) Communication Technology Based Services (CTBS) 3.) Remote Monitoring Services Join the discussion: Urology Coding and Reimbursement Group - Join for free and ask your questi...

Mark, Ray and Scott answer 3 questions from the Urology Coding and Reimbursement Group Scenario: New patient being seen via telemedicine for the first visit. Dr. has ER reports and a CT with finding of "a nodular mass-like extension from the left posterior aspect of the prostate into the seminal vesicle and an impression of "Probable prostate cancer extending into the left seminal vesicl...