Urology Coding and Reimbursement Podcast

November 15, 2024  Ray, Mark, and Scott talk about the CMS Final Rule for 2025 in part 2 of this two-episode discussion. 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 Semi...

November 8, 2024  Ray, Mark, and Scott talk about the CMS Final Rule for 2025 in part 1 of this two-episode discussion. 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 Semin...

N ovember 1, 2024  Ray and Scott talk PRS MS Director of Operation, Marianne Desciose about Revenue Cycle Management (RCM) current and sometimes hidden issues. 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...

UCR 217: Split shared and incident to visits October 25, 2024  Ray, Mark, and Scott talk about split shared and incident to visits. 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 Reimbur...

October 18, 2024  Ray, Mark, and Scott talk about the top 3 ICD-10 Challenges of 2024. 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...

October 11, 2024  Ray, Mark, and Scott discuss the upcoming Urology Advanced Coding and Reimbursement Seminar, why you should attend, and the agenda for the upcoming seminars. 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...

October 4, 2024  Ray, Mark, and Scott talk about the Telehealth status, payer down coding, and level 5 E/M services in urology Urology Coding and Billing Certification Course for Coders, Billers, and Admins Use code: DCBSE24 for a special price through October 7th, 2024. Now is the best time to invest in training. ​Click to Register PRS Billing and Other Services - Book a Call with Mark Painter or...

 September 27, 2024  Ray and Scott welcome guest Marianne Desciose to discuss Prior Authorizations, Pre Certifications, and Eligibility.   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...

September 13, 2024  Mark, Ray, and Scott discuss questions from the PRS Community. Hi,   In your Urology Times article on July 30th, there is mention of a proposed change to the practice expense component of cystoscopy due to updates in the supply valuation by CPT RVU Update committee.  It talks about "packs SA045, SA058 and SA042".  What are these packs and can you explain further how t...

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...

August 30, 2024  Mark, Scott, and Ray talk about questions that came into the PRS Communities. 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 shoul...

August 23, 2024  Mark, Scott, and Ray talk about two questions that came into the PRS Communities: 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...

August 16, 2024 Mark, Scott, and Ray talk about G2211 and 99459 updates and two CPT description questions that came into the PRS Communities: I have received a denial for px 50545 stating the adrenal gland was not removed, therefore,  50545 is not supported.  PX description:  Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal...

August 9, 2024 Mark and Scott discuss the 2025 Proposed CMS Rules.    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 Her...

August 2, 2024 Mark, Scott, and Dr. Ray Painter discuss FAQs that came into the PRS communities.   Can you bill a voiding trial after a patient had a procedure that has 0 day global (UROLIFT). Hi, a question on IPP coding pls. How do you we code for "2-piece Ambicore IPP placement"?  With this new Ambicore IPP, the penile prosthesis consists of only One pair of Cylinders and a Pump and e...

July 26, 2024 Scott, Mark, and Dr. Ray Painter interview Dr. Willie Underwood, a urologist with over 20 years of experience and a key figure in the American Medical Association's leadership. Dr. Underwood discusses the importance of physician involvement at state and national levels, the AMA's stance on telehealth advancements, and the necessity for collective action and financial contri...

July 19, 2024 Scott, Mark, and Dr. Ray Painter explore effective billing practices for Part B drugs, using Jelmyto as an example. They discuss challenges such as prior authorizations, correct dosing, and site-specific billing considerations, emphasizing the need for accurate documentation and communication within healthcare settings. The episode also highlights strategies to manage Medicare and pr...

July 12, 2024 Scott, Mark, and Dr. Ray Painter are joined by Dr. John Lin.  In this episode, they answer two questions that came into the Thriving Urology Practice Facebook group: Pearl: We use 55700 for the MRI fusion prostate biopsy. The docs want to use 55706 instead when MRI fusion biopsy is done with the transperineal approach. Is that OK?   Kimberly: Can someone please explain to me if codes...

June 28, 2024 Scott, Mark, and Dr. Ray Painter are joined by Dr. Eugene Rhee, a key figure in urology and healthcare policy. Dr. Rhee, who recently completed his term as Chair of the AUA Public Policy, shares his insights on the challenges facing urology, notably the supply-demand gap in the workforce, and the increasing importance of telemedicine. The discussion covers the impact of the pandemic...

June 21, 2024 Mark, Scott, and Ray celebrate their milestone episode by reflecting on the origins, achievements, and future goals of the podcast.    Urology Advanced Coding and Reimbursement VIRTUAL SEMINAR Register Now for the Urology Advanced Coding and Reimbursement Virtual Seminar Join us on July 27th, 2024 , for a live Zoom meeting from 9:30 am to 1:30 pm EST, and master the latest in urology...

J une 14, 2024 Mark, Scott, and Ray discuss topics that came into the PRS communities.     Can you bring this back up again as it relates to Audio only calls. Question i have is if you are just reviewing results that were ordered during a visit, this is essentially not a billable event. Isnt it considered double dipping because the review of the results and test order is included when ordered. Asi...

June 7, 2024 Mark and Scott discuss FAQs that came into the PRS communities.   Are you obligated to bill the new Category 3 CPT code for penile shockwave therapy, which we currently provide as a cash service? Specifically, do we have to use the Category 3 code when billing Medicare patients, even though there is no payment associated with it, and can we continue collecting cash without making it a...

May 31, 2024 Mark and Scott welcome Marianne Desciose to discuss what are the biggest issues right now in RCM.     Urology Advanced Coding and Reimbursement VIRTUAL SEMINAR Register Now for the Urology Advanced Coding and Reimbursement Virtual Seminar Join us on July 27th, 2024 , for a live Zoom meeting from 9:30 am to 1:30 pm EST, and master the latest in urology coding and reimbursement with eas...

May 24, 2024 Mark, Ray, and Scott welcome Dr. Una Lee and Dr. John Lin to share their thoughts about their AUA IBL presentation "The Business of Urology – What I have Learned on How to be Clinically Productive"    Urology Advanced Coding and Reimbursement VIRTUAL SEMINAR Register Now for the Urology Advanced Coding and Reimbursement Virtual Seminar Join us on July 27th, 2024 , for a live...

May 17, 2024 Mark, Ray, and Scott discuss FAQs that came into the PRS Network Community. Are there payers not paying for 99459? Hello, the max units for J2704 is 80.  I have searched and searched and can't figure out how to bill additional units if more than 80 units is administered.  I have tried modifier 59 and my claim was still denied. Any help would be greatly appreciated. Can we bill 13...