Urology Coding and Reimbursement Podcast

October 28, 2022 Mark and Scott discuss the Day 1 agenda for the Urology Coding and Reimbursement Seminar what we included and why it's important right now.  Urology Advanced Coding and Reimbursement Seminar Day 1 Agenda 8:00 PreService/Front Office: Strategies to promote, maintain, and enhance optimal front office workflow - How to make the Front Office work for you. 10:15 E/M 2023 Interacti...

October 21, 2022 Mark, Ray, and Scott welcome back special guest Dr. John Lin.  They discuss two questions that came into the Thriving Urology Facebook Group: It is possible to have a billable "pre-operative clinic visit" with an APP before surgery but after the visit where the decision for surgery was made?  The proposed purpose is to make sure clearances and cultures are done prior to...

October 14, 2022 Mark, Ray, and Scott welcome special guest Dr. John Lin.  Dr. Lin shares he almost lost over $8k due to documentation/appeal snafu and how he finally won it at the ALJ level. Dr. Lin is the administrator of The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/     Urology Advanced...

October 7, 2022 Mark, Ray, and Scott discuss ICD-10 in week 2 of Urology Coding Month (October).  Mark gives the ICD-10 overview as it pertains to urology and shares current denial trends. Monthly Webinar Webinar Topic: Will the NEW CPT CODES for January help solve current coding problems? Now Free to All Thank You to Our Monthly Webinar Series Partner: ModMed (learn more at  https://www.modmed.co...

S eptember 30, 2022 Mark, Ray, and Scott kickoff the Urology Coding Month (October) with a discussion of rules and why its so important to know what they are and how to apply them.  Also, as an example they discuss a few of the new 2023 CPT codes for urology. Monthly Webinar Webinar Topic: Will the NEW CPT CODES for January help solve current coding problems? Now Free to All Thank You to Our Month...

Available September 23, 2022 Mark, Ray, and Scott discuss Pediatric Urology Coding and some of its nuances.  Also, they answer 2 pediatric urology coding questions: I think the great majority of us know that if a patient has been seen by me or one of the other providers in my practice within the past three years then he/she is considered an established patient. However, there is some controversy i...

September 16, 2022 Mark, Ray, and Scott discuss Pediatric Urology Coding and some of its nuances.  Also, they answer 2 pediatric urology coding questions:  Case was for non-palpable testis(UDT) so plan was laparoscopic approach for UDT and, at time of laparoscopy, no intraabdominal testis found, so an open exploration with separate incision was done and atrophic testis found in canal. billed as di...

September 9, 2022 Ray and Scott discuss why it is so hard to get paid accurately for all the services provided. Test Your Knowledge - What is your urology coding score? https://www.prsnetwork.com/uroscore  Free Urology Coding Training For Residents https://www.prseducationfoundation.org Urology Advanced Coding and Reimbursement Seminar  - Registration Open Las Vegas, NV - December 2-3, 2022 New Or...

September 2, 2022 Mark, Ray, and Scott discuss what you should do when you have a surgery that includes both open and laparoscopic approaches.  Also, Mark recaps the Monthly Webinar "How to avoid unspecified diagnosis denials". Link to Monthly Webinar: "How to avoid unspecified diagnosis denials" Urology Advanced Coding and Reimbursement Seminar  - Registration Open Las Vegas,...

August 26, 2022 Mark, Ray, and Scott discuss the reliability of a manufacturer's coding guidance and the Discarded Drug Rebate in the CMS proposed rule for 2023. Urology Advanced Coding and Reimbursement Seminar  - Registration Open Las Vegas, NV - December 2-3, 2022 New Orleans, LA - January 27-28, 2023 Register Now   Compliance Plans Questions or need help, please send us an email: info@prs...

August 19, 2022 Mark, Ray, and Scott discuss questions that came into the PRS community: I just listened to the podcast on Order of modifiers on a claim. Just one question. I've been taught that the global modifier doesn't apply to an assistant surgeon. So if the patient is in a global you wouldn't add the 78 or 79 modifier to their claim. It would only be added to the primary surge...

August 12, 2022 Mark, Ray, and Scott discuss how modifiers should be ordered.  Mark shares what modifier sequencing is, why modifier sequencing is important and provides examples of how to order modifiers on a claim. Urology Advanced Coding and Reimbursement Seminar  - Registration Open Las Vegas, NV - December 2-3, 2022 New Orleans, LA - January 27-28, 2023 Register Now   Compliance Plans Questio...

August 5, 2022 Ray, Mark, and Scott discuss two questions that came into the Urology Coding and Reimbursement Gropou about billing a TURBT even though the whole tumor was not removed also they discuss coverage of repeat Urolift procedures. PRS Education Foundation https://www.prseducationfoundation.org Urology Advanced Coding and Reimbursement Seminar  - Registration Open Las Vegas, NV - December...

July 29, 2022 Ray, Mark, and Scott discuss a question regarding injection codes and why it may be an excellent decision to bill the injection code even though you know it will probably be denied.  Compliance Plans Questions or need help, please send us an email: info@prsnetwork.com    Join the discussion: Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your...

July 22, 2022 Ray, Mark, and Scott discuss a question regarding antegrade ureteroscopy with laser lithotripsy to treat a ureteral stone and compliance plans.  Compliance Plans Questions or need help, please send us an email: info@prsnetwork.com    Join the discussion: Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom. Click Here to Start Your Free...

July 15, 2022 Ray, Mark, and Scott discuss the 2023 CMS Proposed Rules and how they will impact Urology Practices.  Mark breaks down what's important to urology in the new proposed rules.  Urologists’ Coding Workshop July 23, 2022 - 10 am - 3 pm EST Register Now Special 5-hour Zoom Workshop: intensive and interactive workshop for practicing urologists and APPs (coders, billers, and admins are...

July 8, 2022 Mark, Scott, and Ray clarify some concept nuances that may have been misinterpreted or misunderstood.  Urologists’ Coding Workshop July 23, 2022 - 10 am - 3 pm EST Register Now Special 5-hour Zoom Workshop: intensive and interactive workshop for practicing urologists and APPs (coders, billers, and admins are welcome to participate). "Beef Up" On your Urology Coding Knowledge...

July 1, 2022 Mark, Scott, and Ray discuss ICD-10 "Unspecified" codes and the increase in denials.  Urologists’ Coding Workshop July 23, 2022 - 10 am - 3 pm EST Register Now Special 5-hour Zoom Workshop: intensive and interactive workshop for practicing urologists and APPs (coders, billers, and admins are welcome to participate). "Beef Up" On your Urology Coding Knowledge PRS Ne...

June 24, 2022 Mark and Scott welcome Dr. John Lin to the podcast to discuss in detail Modifier -25. Skyline Urology to Pay 1.85M to Settle False Claims Act Allegations of Medicare Overbilling  https://www.justice.gov/opa/pr/skyline-urology-pay-185-million-settle-false-claims-act-allegations-medicare-overbilling  Also Corporate Integrity Agreement  OIG Audit Modifier 25 https://oig.hhs.gov/oei/repo...

June 17, 2022 Mark and Scott discuss the most popular topics of the first 100 episodes and why they were popular.  ​NEW ONLINE WORKSHOP - Urologists’ Coding Workshop Special 5-hour virtual, intensive, and interactive workshop for practicing urologists and APPs (coders, billers and admins are welcome to participate). "Beef Up" On General Coding Knowledge PRS Network Presentation Team Dr....

June 10, 2022 Mark, Scott, and Ray discuss questions that came into the PRS Community Forum   1) Can we bill for cpt 76377 or it is considered a Radiology procedure. My doctors want some direction if we can bill for this during prostate biopsy. Do you have any advice on this? Thank you so much! 2) We have a small path lab and pathologist will be out of town for a week and we are trying to figure o...

Available June 3, 2022 Mark, Scott, and Ray discuss Mark's call with a payer making the argument that an E&M service can be billed with a Vasectomy on the same day.  ​NEW ONLINE WORKSHOP - Urologists’ Coding Workshop Special 5-hour virtual, intensive, and interactive workshop for practicing urologists and APPs (coders, billers and admins are welcome to participate). "Beef Up" On...

May 27, 2022 Mark, Scott, and Ray discuss questions that came into the PRS Community Forum. 1. Independent historian. For pediatric visits, I'm a little unclear what counts as an independent historian. I see the definition from CMS indicates "an individual (eg, parent, guardian, surrogate, spouse, witness) who provides a history in addition to a history provided by the patient who is una...

May 20, 2022 Mark, Scott, and Ray talk about the recent AUA Annual meeting in New Orleans.  Also, we had a question come in about using the same data in medical decision making in two different encounters.  Can you count the same category 1 data twice?  ​NEW ONLINE WORKSHOP - Urologists’ Coding Workshop Special 5-hour virtual, intensive, and interactive workshop for practicing urologists and APPs...

May 6, 2022 Mark, Scott, and Ray discuss a question about a scenario regarding coding the most comprehensive code: Scenario 6 module 9, Cystectomy, with continent diversion, bilateral pelvic lymphadenectomy and prostatectomy. I captured both 55845 and 51596 and I also looked at the possibility of 51575 (Cystectomy with bilat lymphadenectomy, 50825 continent diversion including intestine anastomosi...