Urology Coding and Reimbursement Podcast

April 29, 2022 Mark, Scott, and Ray discuss two current topics: 1)  Letter of notification from CMS/Qlarant, a provider was selected for prepayment claim review. We have received two record requests from them on urine PCR code 87798.  2)  United Health Care proposing a plan to encourage e-consults for urology providers.  ​NEW ONLINE WORKSHOP - Urologists’ Coding Workshop Special 5-hour virtual, in...

Available April 22, 2022 Mark, Scott, and Ray answer questions 1)I have been asked if it is appropriate to bill for "misfired" Urolift implants? 2)  I know Jon's opinion on this, but was wondering what the Painters think....chief complaint--do you have to be more detailed than stating "follow up"?  ​NEW ONLINE WORKSHOP - Urologists’ Coding Workshop Special 5-hour virtual,...

Available April 14, 2022 Mark, Scott, and Ray answer questions 1) If a patient is being set up for a telemedicine visit with an MD in the MD's secondary clinic and the MD is in his/her primary clinic.  Do we bill under the primary clinic with a place of service 02? Also, should documentation support where the patient is located? 2)  How should I code for Bladder Interstitial Fiducial Marker p...

Available April 8, 2022 Mark, Scott, and Ray answer questions 1) My clinic is trying out the app through Emano Flow that tracks a patients urine flow for 14 days and then the Urologist goes over the results with the patient when the trial is finished. My clinic is very confused on whether or not each individual day needs an interpretation written by the doctor in order to bill a uroflow (51741) on...

April 1, 2022 Mark, Scott, and Ray discuss an update on the MolDx guidelines for PCR billing set to take effect on April 17th, 2022.  They also talk about Modifier -22; should you use it and what it takes. UTI – PCR UPDATE The following Medicare Administrative Contractors (MAC) aka Carriers, have issued a proposed multi-jurisdictional Local Coverage Decision (LCD) for Multiplex Nucleic Acid Amplif...

March 25, 2022 Mark and Scott discuss the new MolDx guidelines for PCR billing set to take effect on April 17th, 2022.  Urology Coding Course Spring Registration Is Open! ​Urology Coding Course for Urologists/QHPs  [Register Now] ​   ​Urology Coding Course for Coders/Billers/Admins  [Register Now] Join the discussion: Urology Coding and Reimbursement Group - Join for free and ask your questions, a...

Mark, Ray, and Scott discuss comments and questions from PRS Forums: PRS Community and Urology Coding and Reimbursement Group: 1)  Re: RE: New Podcast Episode: -TC and -26 modifiers - Urodynamics billing: split or global? (3/11/22) If the UDS tests are done on Monday and the ordering doc isn’t in the clinic, but there is a supervising doc, I know we would bill for the TC under the supervising doc....

March 11, 2022 Mark, Ray, and Scott discuss -TC and -26 billing for urodynamics.  There was a rule change in 2019 that updated how urodynamics should be billed in regards to the -TC and -26.  Prior to that rule change, we recommended split billing but now recommend the global billing. Below is the question that prompted this discussion: Can we bill a TC and 26 modifiers on same day for the 51728,...

March 3, 2022 Scott and Ray discuss the upcoming free webinar [March 10th, 2022]: How to Tell if You Need More Urology Coding Training and How to Get It They discuss why it is important to understand what you know.     Link to Register for the Free Webinar How to Tell if You Need More Urology Coding Training and How to Get It Register Now  PRS Education Foundation Free Urology Resident Training! ...

February 22, 2022 Mark, Scott, and Ray discuss how to answer the question below and how to approach answering similar questions:  What would be the appropriate CPT codes to bill for Pelvic Wave (pelvic floor PT)? Urology Advanced Coding and Reimbursement Seminar - The Recordings REGISTRATION OPEN Information and Registration   Urology E&M Workshop - Recordings Over 5 Hours of UROLOGY E/M Train...

February 11, 2022   Mark, Scott, and Ray discuss why data is so important and how you can learn more in the upcoming Free Webinar:  Essential Coding and Billing Data and Reports for Urology Practices Workshop (2/17/22) More information and registration    Urology Advanced Coding and Reimbursement Seminar - The Recordings REGISTRATION OPEN Information and Registration   Urology E&M Workshop - R...

February 4, 2022   Mark, Scott, and Ray discuss contracts and answer questions about the No Surprises Act.    Urology Advanced Coding and Reimbursement Seminar - The Recordings REGISTRATION OPEN Information and Registration   Urology E&M Workshop - Recordings Over 5 Hours of UROLOGY E/M Training!  Information and Registration   Join the discussion: Urology Coding and Reimbursement Group - Join...

January 21, 2022   Mark, Scott, and special guest Dr. John Lin discuss the No Surprises Act.   Mark provides an overview of the act and the three discuss how will the act is going to impact urologists and urology practices. AMA: Implementation of the No Surprises Act AMA toolkit for physicians: Preparing for implementation of the No Surprises Act From CMS: Provider requirements and resources (No S...

J anuary 14, 2022   Mark, Ray, and Scott discuss the new modifiers and urodynamics coding     Urology Advanced Coding and Reimbursement Seminar - Virtual Event REGISTRATION OPEN Live Online Event Information and Registration Online - January 28-29, 2022   Join the discussion: Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.  Click Here to Start...

January 6, 2022   Mark, Ray, and Scott discuss the change of the Urology Advanced Coding and Reimbursement Seminar from in-person to online.  Mark provides an update on the QPP reporting that was just announced.  The PRS 2022 event calendar is previewed.     Urology Advanced Coding and Reimbursement Seminar - Virtual Event REGISTRATION OPEN Live Online Evengt Information and Registration Online -...

December 21, 2021 Ray and Scott discuss and answer questions from the PRS Communities. 1) I have a question regarding BPH w/LUTS; if a patient is treated successfully with a TURP, no longer having any LUTS, would the diagnosis then be BPH w/o LUTS (N40.0) or would it be Personal Hx of disease of other male genital organs (Z87.438) 2)  If a patient is in the office for the postop visit after prosta...

December 13, 2021 Ray and Scott discuss the highlights of the Seminar and share some of the takeaways for each session. Urology Advanced Coding and Reimbursement Seminar REGISTRATION OPEN Live In-Person Event Information and Registration New Orleans, January 28-29, 2022   Join the discussion: Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.  Cli...

December 9, 2021 Ray and Scott discuss the highlights of the Seminar and share some of the takeaways for each session. Urology Advanced Coding and Reimbursement Seminar REGISTRATION OPEN Live In-Person Event Information and Registration New Orleans, January 28-29, 2022   Join the discussion: Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.  Clic...

December 1, 2021 Mark, Ray, and Scott discuss a correction to the preliminary analysis of the 2022 payment changes to the ASC payment for Urolift.  They also discuss the final agenda of the upcoming 2022 Urology Advanced Coding and Reimbursement Seminar (December 3rd - 4th, 2021 Las Vegas and January 28th - 29th, 2022 in New Orleans)   Urology Advanced Coding and Reimbursement Seminar REGISTRATION...

November 15, 2021 Mark, Ray, and Scott discuss some E&M 2021 FAQs. Is pyuria and hematuria 2 points or one?   If it appears to be clearing, would it still be considered “with exacerbation”? Can a problem be considered chronic if you expect the problem will last >1 year or it is only considered chronic if the problem has existed for >1 year?   If Medicare does not cover Bladder Scans for...

October 22, 2021 Mark presents the preliminary summary of the newly released CMS 2022 Final Rule Urology Advanced Coding and Reimbursement Seminar REGISTRATION OPEN Live In-Person Events Information and Registration Las Vegas, December 3-4, 2021 New Orleans, January 28-29, 2022   Join the discussion: Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisd...

October 22, 2021 Mark, Ray, and Scott discuss the PHE, telehealth place of service update, and urology Coding Month finale. Free E&M Training - 4 Sessions (30 minutes each) Session #1 - Why E&M 2021 is So Important [ 10/25/21 at 3-3:30 pm EST] Session #2 - Medical Decision Making 2.0: Problem, Risk and Data [ 10/27/21 at 2-2:30 pm EST] Session #3 - Time, Shortcut Tools, and Best Practices...

October 15, 2021 Mark, Ray, and Scott revisit a question from Episode 068 about an Implantable Penile Prosthesis. Also, they discuss several additional IPP questions.  Finally, they had a question about PTNS that sparked an "Incident To" clarification discussion. Free E&M Training - 4 Sessions (30 minutes each) Session #1 - Why E&M 2021 is So Important [ 10/25/21 at 3-3:30 pm EST...

October 12, 2021 Mark, Ray, and Scott discuss the new Urology CPT and ICD-10 Codes. Urology Residents Coding and Documentation for Urology Residents More Information and Registration Urology Advanced Coding and Reimbursement Seminar REGISTRATION OPEN Live In-Person Events Information and Registration Las Vegas, December 3-4, 2021 New Orleans, January 28-29, 2022   Join the discussion: Urology Codi...

October 1, 2021 Ray, Mark, and Scott discuss the global surgical package and the global days. Understanding these concepts is critical to understanding the basics of coding. Urology Residents Coding and Documentation for Urology Residents More Information and Registration Urology Advanced Coding and Reimbursement Seminar REGISTRATION OPEN Live In-Person Events Information and Registration Las Vega...