Urology Coding and Reimbursement Podcast

May 10, 2024 Mark and Scott discuss FAQs that came into the Urology Coding and Reimbursement Group. MRI fusion biopsy update Hi, Can you please help us with the below questions.   Pessary Insertion – does it require a physician to be onsite? What about Pessary cleaning? Urodynamics – we know that Medicare requires a physician to be onsite, does this also apply to commercial payers? Biofeedback - w...

April 26, 2024 Ray, Mark, and Scott discuss the upcoming AUA Annual meeting in San Antonio and what PRS plans to do there. New Courses Available for Urologists and Urology APPs Documentation 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% Certificat...

April 19, 2024 Ray, 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 APPs Documentation for Reimbursement Challenge for Urologists ​ Use Special Discount Code: DRC5624 and Save 36%   ​Documentation for Coding and Reimbursement for APPs ​ Use Special Discount Code: DCRA56...

April 12, 2024 Mark 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 5...

April 5, 2024 Mark, 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 criti...

M arch 28, 2024 Mark, 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 Services Click Here to Get More Information and Request a Quote    The Thriving Urology Practice Facebook group. The Thriving Ur...

March 22, 2024 Mark, 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 medi...

March 15, 2024 Mark, 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 you Hello, I need help. I am having issues with multiple insurance companies denying diagnosis code N30.10 stating it is an inval...

March 8, 2024 Mark, 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 o...

M arch 1, 2024 Hosts 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 3/11/24 Click Here for Information and to Join PRS Billing and Other Services Click Here to Get More Information and Request a Quote    The Thrivin...

February 23, 2024 Mark, 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 epis...

February 16, 2024 Ray 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...

 February 9, 2024 Ray, 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...

February 2, 2024 Ray, 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: Ureteroneocystost...

January 19, 2024 Scott 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 dur...

January 12, 2024 Scott 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, 2024 8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday R...

January 5, 2024 Mark, 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 Document Click 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 & 2...

December 29, 2023 Mark, 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 and 9 o’clock positions. 2 s...

D ecember 22, 2023 Mark, 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 s...

 December 15, 2023 Mark, 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, 2024 8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday Reserve your spot and save !   Get signed up today and ge...

December 8, 2023 Mark, 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, 2024 8 am - 4:3...

December 1, 2023 Mark, 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, 2024 8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday Reserve your spot and save !   Get signed up today and get pe...

November 22, 2023 Mark, Ray, and Scott discuss Part B drugs and how a practice can compare clinically similar drugs.   Telehealth Resource Centers https://telehealthresourcecenter.org/ Urology Advanced Coding and Reimbursement Seminar (Click Here for More information and Registration)   Las Vegas, December 1 & 2, 2023 8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday New Orleans, January 26 &...

November 17, 2023 Mark, Ray, and Scott have a conversation with Dr. Finkelstein about Telehealth in Urology. Dr. Finkelstein's expertise illuminates key considerations for urologists seeking to harness the potential of telemedicine, offering a roadmap for successful implementation. This episode equips listeners with invaluable knowledge to navigate and leverage telehealth for enhanced patient...

November 10, 2023 Mark presents the summary of the newly released CMS 2024 Final Rule.   Urology Advanced Coding and Reimbursement Seminar (Click Here for More Information and Registration)   Las Vegas, December 1 & 2, 2023 8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday New Orleans, January 26 & 27, 2024 8 am - 4:30 pm Friday, 8 am - 3:30 pm Saturday Reserve your spot and save !   Get sign...