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May 9, 2025 In this episode, Scott, Mark, and Ray answer questions that came into the PRS Helpdesk.One of my specialties is pedsurology and there is just not much guidance for surgery coding.Is it appropriate to use 54360 (plastic operation on penis to correct angulation) for correction of penile torsion?I found an article from AAPC dated 2005 that stated to use 14040 for penile torsion repair when performed with a MAGPI hypospadias repair (54322).What if the penile torsion repair is not performed with another procedure or at least without a hypospadias repair?If Medical technologists (Medical assistants trained to perform Urodynamics) can perform this test why are Medical assistants not permitted by CMS to perform catheter insertion and removal in non regulated sites of services? (I have seen MAs in non regulated spaces perform catheter changes, bladder instillations--etc---how are practices able to get away with having MAs incorporated in their work flow as such?)In regulated sites of service (Hospital based clinics) what documentation should be used to ensure proper billing when an MA performs 51798 (bladder scan) (incident to billing for a hospital-employed physician).Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
May 2, 2025 In this episode, Scott, Mark, and Ray share highlights from the AUA 2025 Annual Meeting in Las Vegas, discussing exciting new technologies, reimbursement challenges, key conversations, and updates from the urology community.Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
April 25, 2025 Scott, Mark, and Ray discuss the pressures of Urology practice in 2025. They talk about what you need to be aware of and why you need to plan for the future.Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
April 18, 2025 Scott, Mark, and Ray discuss questions that came into the PRS Helpdesk:For the past 8 months, I have been in an employed position with a county hospital system that provides inpatient and ambulatory services. Their coding consultants (acsteam.net) are telling the hospital that foley catheter insertions, bladder irrigations, and a list of other procedures commonly performed in urology clinics cannot be billed if they are not performed personally by the physician according to CMS. They reference a list of procedures from CMS and state that these services cannot be billed when performed by ancillary staff regardless of the level of supervision. They use https://www.cms.gov/status-indicators as their source citing the section on PC or TC indicators. Can this be true? Is it possible that this consultant is giving advice from a hospital perspective and not aware of differences between the ambulatory setting? The urology clinic I am working in is not a department of the hospital. It is freestanding. I have never worked in a clinic that did not bill for these services performed by ancillary staff with physician supervision.I look forward to your response.Good afternoon, my question is regarding "Incident to" required documentation. When we attended your seminar this past December, on Day 2, the new "Incident to Rule" was discuss. Can you please help clarify the new rule? My notes are not clear.We are in the process of CMS Review -"Targeted Probe and Educate Round 1". The letter states we were chosen for review because of being in the 60th percentile for our jurisdiction for code 99214.Our practice has the challenge of servicing and underprivilege community and estimated population of 590,142. We have 7 Urologist, 4 Apps and 1 Radiation Oncologist in our practice. Hence our volume is overwhelming.Earlier this year we submitted a batch of approximately forty records. Today we received a notification request "Incident to documentation: needed 2 previous office visits done by MD to support physician/supervising provider's initiation and continued involvement in treatment, and documentation to support direct supervision met.I appreciate any assistance with clarifying the “Incident to” rule.Thank you in advance for your assistance.Doctor did a stent pull in the ASC but not with Cysto scope. How would we go about billing this?Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ © 2025 Physician Reimbursement Systems, Inc.Home
April 11, 2025 Scott and Mark discuss questions that came into the PRS Helpdesk:Hello, Some years ago we were using the SRS urocuff. Can you tell me what the current codes are? I know this has been mentioned at the seminars- cannot find the slide :( ThanksHow are groups coding for the new Revi procedure for urge incontinence, urgency of urination, for both professional and facility fees. Is it best to use a 0817T or a 64581 w/ crosswalk? Cannot find a lot of information about this. Any feedback or suggestions would be greatly appreciated!I would like your thoughts about the use of Pelvic Floor rehab CPT code 91122 in a urology practice. The company UroVal Inc. is promoting this procedure for urologists to perform in the office setting.E/M question pls. Thank you! For a follow up office visit, Pt has prostate cancer, and he is on "Active Surveillance". For Problem Component of E/M, would you consider pCA on Active Surveillance is a Moderate VS a Low-level problem? (as opposed to personal history of pCA - Watchful Waiting). I think it's a moderate level 4, but would like to hear your opinion, thank you!!Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
April 4, 2025 Scott and Mark discuss who can perform biofeedback services, clarify billing requirements, and explore practical scenarios involving incident-to billing. Mark and Scott break down key Medicare guidelines, share best practices for documentation, and offer tips for optimizing biofeedback delivery within your urology practice.Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
March 28, 2025 Scott, Mark, and Dr. Ray Painter discuss questions that came into the PRS Helpdesk. NGS sent a newsletter about the use of: cpt code G0463 as a primary code for G2211. Need more info if possible.Do nurse practitioners get paid at 100% for procedures like a PNE when signing notes in NM by themselves?a) Medicare NGS is denying CPT 52332 for bilateral stents with denial CO-151. This seems to be a constant problem with denials for frequency and/or bilateral stents.Has the policy been changed; I have not been able to find any changes regarding stents insertion or exchanges.Thanksb)Hi,Wondering if you can help me with this Medicare patients.NGS is denying the claim on several patients stating that this code has a frequency limit on 52332.NGS has a problem with both frequency and bilateral stentsI have searched everywhere and find no information on this code for frequency limits per year or bilateral stents.Appreciate any help on this code.Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
March 21, 2025 Scott, Mark, and Dr. Ray Painter break down the latest developments in telehealth policy and Medicare reimbursement. Mark shares the good news about the extension of telehealth flexibilities and the bad news regarding the unchanged (and still reduced) conversion factor. They also dive deep into the recent uptick in RAC audits, highlighting the procedures being targeted, documentation pitfalls to avoid, and best practices for navigating the audit and appeals process. Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
March 14, 2025 Scott, Mark, and Ray discuss three coding questions from the PRS Community and the Thriving Urology Practice Facebook group. My question is regarding G2211. Is there a time frame for the follow-up that needs to be dictated. My doctor has been putting return to clinic in a year in the notes and billing G2211. Wondering if this is ok, or if the follow up must be sooner?Our new urologist started placing an amniotic tissue membrane graft around the urethral anastomosis during a laparoscopic robotic radical prostatectomy. Would this be included in the 55866 or is there a CPT code for this? I was looking at 15275 but not sure if that is correct either. I am a coder with questions.Would you be so kind to give me your opinion on 50548 for robotic radical nephroureterectomy versus using 50545 for that surgery?Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
March 7, 2025 Scott, Mark, and Ray discuss the latest updates (or lack thereof) on telehealth policies as the current extension nears expiration. They break down what practices should consider when scheduling telehealth visits, the potential impact of congressional actions, and how to prepare for possible changes.The second topic dives into specialty designations within the same practice—what happens when different taxonomy classifications exist under the same tax ID, and how this affects new vs. established patient billing.Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
February 28, 2025 Scott, Mark, and Dr. Ray Painter break down the challenges of securing fair compensation for extra work performed in urology procedures when using modifier 22, unlisted codes, or Category III codes. They discuss effective strategies for communicating with payers and contract administrators, ensuring proper documentation, and negotiating fair work RVU adjustments.Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
February 21, 2025 Scott and Mark discuss questions from the PRS Network Community and the Thriving Urology Practice Facebook group.Does anyone bill out a removal of testicular appendix separately from the hydrocelectomy? I have a new physician that is submitting 55040 and 54512.After presenting Grand Rounds on billing/coding the question arose that our billing department is billing g G2211 with a modifier 25 and getting paid. That goes against what I learned and what I presented. Leveraging Provider PortalsFree Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
February 14, 2025 Scott, Mark, and Ray discuss questions that came into the PRS Network Community.Our doctor's occasionally use the ESWL (Extracorporeal Shock Wave Lithotripsy) for bladder stones. Insurance requires a laterality modifier. I am not sure if we can bill for it or not. If we can bill for it, what is the correct way to do it?Can you please clarify the relaxation of the in person requirement for supervision in 2025? As I read it and as I understand that you have explained it, this is a new rule stating essentially that if I am a physician supervising a nurse practitioner, the in person supervision is waived and I only need to be available via telecommunication. Am I interpreting this correctly? My coders are pushing back saying that this only applies to telehealth visits not in person visits for my supervisoion of a nurse practitioner.Coding Challenging Stone Cases: Is there a CPT code I'm missing here? What financial incentive is there to use the suction/vacuum technology and perform FANS/DISS for larger stones? Just the 22-modifer? Seems like from a billing/time perspective, it's not worth tackling larger stones with either FANS or DISS. Does the 22-modifier really make that much difference? Can you provide an example of generally what additional time (ie double/triple, etc) actually generates for additional RVUs? Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
February 7, 2025 Scott and Mark welcome back Dr. John Lin and Marianne Descoise to discuss some key takeaways from the Urology Advanced Coding and Reimbursement Seminar, which took place in New Orleans from January 31st to February 1st. Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
UCR 228: G0559 clarification, GC Modifier Explained, and G2211 documentation suggestion.January 24, 2025 Scott, Mark, and Dr. Ray Painter address questions submitted to the PRS Network.I recently attended your Billing and Coding conference in Las Vegas this past December. I need clarification on New CPT code G0559, can someone please contact me as soon as possible.From a coding perspective, I have a question regarding the GC modifier for a teaching facility. Also, is there a difference between the coding perspective and the compliance side of the question?How crucial is adding the modifier GC to the encounter when a patient is seen by both the Resident and the Faculty member?Appreciate any insight y'all can provide.My coder is requiring me to add a statement for G2211 codes."E and M visit today is associated with current or anticipated ongoing medical care services related to a patient's single serious condition or complex condition."Is this necessary? Reading the CMS guidelines they say no. They are worried about "Bulletproof" Documentation. I am coding these with many of my follow up patient who have chronic BPH, OAB, ED and cancer. Thoughts on how to respond to them? Free Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminar - New Orleans, LARegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:New Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUsClick Here to Start Your Free Trial of AUACodingToday.com
Get More Information on Virtual Lessons HERE https://stridesforsuccess.com/virtual The world has changed and access to riding instructors and trainers has changed with it... Virtual horse riding lessons are now so easy to schedule, that riders can connect with trainers from all over the world. Not just the ones who live locally or are willing to travel to their barn or property. So, whether you're juggling a hectic schedule or living far from an experienced or suitable instructor, there's no need to put your riding goals on pause anymore. Virtual horse riding lessons are an absolute game changer and I want to tell you how they can help you as well. Why Virtual Horse Riding Lessons? As I mentioned, life is busy. Virtual lessons can help to navigate this a little more than traditional lessons. There's no boxing or trailering horses to a different barn. There's also the opportunity to choose times for lessons that may not suit 'in-person' and local instructors. And finally, if you have decided to 'opt out' of the busyness of modern life by moving to the countryside; you can still train with an instructor that you enjoy. Not just having to make do with whoever is willing to travel to you! Virtual horse riding lessons mean that you still have regular lessons, expert guidance, personalized feedback, and goal-oriented training without the hassle of travel or scheduling conflicts. Virtual lessons will allow you to work on improving your skills while training your horse. And this is all done in your own arena - you're no longer limited by geography! Read the Full Article & Listen HERE https://stridesforsuccess.com/episode1348-how-virtual-horse-riding-lessons-can-transform-your-riding Give Virtual Lessons a Go... Right now, you can purchase a single once-off virtual horse riding lesson with me. We will get to connect initially via a private chat. I will create a short video review for you of a previous but recent video of you riding your horse. Then we will create a time that suits you to meet in your arena - virtually. After the lesson, I'll send you the recording with some 'homework' for you to work on over the coming weeks and months. Whether you're aiming to perfect your position, work on your horse's responsiveness, or simply gain confidence in the saddle, our once-off virtual lesson will help. Then, if you want to go further, we can work together Inside of Connection where you'll have access to: Virtual Private Real-Time Horse Riding Lessons every month Personalized feedback between lessons with video reviews Private 1-to-1 Chat to hold you accountable and keep you moving Expert guidance to help you troubleshoot challenges as they arise. And most importantly, the flexibility to train when and where it works best for you! You don't have to feel stuck in your riding or let distance be a roadblock. With virtual horse riding lessons, we can work together to ensure you keep moving forward—one ride at a time. If you're ready to transform your riding and get the instruction, training, and accountability you want, check out the details and join me inside Connection here. Your next breakthrough is just a click away! Happy Riding Lorna Connect with Lorna online:- Connect in the Daily Strides Podcast Online Community https://www.facebook.com/groups/dailystridespodcast Connect in the Virtual Stable Lounge Private Group https://www.facebook.com/groups/1499737810323191 Get Going in Your Riding:- Daily Strides Premium is back! You can use the first and original audio horse riding lessons to improve your riding, train your horse, keep things interesting, and have fun… Even if you don't have a trainer or coach Start today:- https://stridesforsuccess.com/dsp Single Private Virtual Horse Riding Lesson Connection; Private Coaching & Virtual Lessons for Equestrians
November 22, 2024 Mark and Scott answer two questions that came in through the coding course:Can you help me to clarify, if the stone in the bladder was fragmented by basket and removed, can we bill CPT 52317 or 52310.Thank you so much!Is it ok to bill CPT 52601 if CPT 0421T denied (for example, Experimental)The provider performed the procedure, what is your suggestion?I really appreciate your help and clarification! PRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Click Here to Start Your Free Trial of AUACodingToday.com
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 DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Click Here to Start Your Free Trial of AUACodingToday.com
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 DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Click Here to Start Your Free Trial of AUACodingToday.com
November 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 DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Click Here to Start Your Free Trial of AUACodingToday.com
UCR 217: Split shared and incident to visitsOctober 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 DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Click Here to Start Your Free Trial of AUACodingToday.com
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 DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Click Here to Start Your Free Trial of AUACodingToday.com
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 DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Click Here to Start Your Free Trial of AUACodingToday.com© 2024 Physician Reimbursement Systems, Inc.Home
October 4, 2024 Ray, Mark, and Scott talk about the Telehealth status, payer down coding, and level 5 E/M services in urologyUrology Coding and Billing Certification Course for Coders, Billers, and AdminsUse code: DCBSE24 for a special price through October 7th, 2024. Now is the best time to invest in training.Click to RegisterPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Click Here to Start Your Free Trial of AUACodingToday.com
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 DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
September 20, 2024 Mark, Ray, and Scott welcome guest Dr. John Lin to share a discussion with a Medical Director and his team from a large payer about what level an undesired fertility, pre-vasectomy, obesity counseling visit should be and the documentation required for reimbursement. PRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
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 this will impact the in-office RVU for CPT 52000? thanksWe are looking for some guidance regarding images and the accessibility. When coding procedures such as 50431 (images included in code) or 51600 or 51610 (images billed separately). Does the coder physically need to see the images before submitting charges? Or can charges be submitted if provider clearly documents images available? We know the images are readily available and are attempting to prevent additional work uploading to the chart for coder review. Should we consider having a written policy in place? Appreciate any advice or suggestions y'all may have. PRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
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 for long-term management. Additionally, the hosts discuss the supervision levels required for radiologic services and recommend AUACodingToday.com for efficient coding. Emphasizing up-to-date knowledge and precision in documentation, the episode closes with insights on adapting to evolving coding regulations.PRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
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 should Not be a billable serviceBut then, Per NCCI, Diagnostic test and procedures may be paid as a separate service during global.Should we bill CPT 52000? and If so, will modifier be -58, since it did not occur in OR so -78 would not be an appropriate modifier? Please suggest, thank you!Modifier 73 Question: Can this modifier be used when the patient is in the pre op area and he/she was given Dilaudid and another mediation and then prepped for surgery but then the patient decided they did not want to proceed because the pain medication made them feel better(Patient had a Kidney Stone). It seems resources were used and a block of time was scheduled for the facility. Wording can be a little different from our MAC, CPT, etc when some state the patient has to be taken to the operating room. Thanks for your time. Hi, We are getting some pushback and would like to know when/if ureteral stents are billable intraoperatively. Our providers are placing a stent, performing pyeloplasty in the same ureter, and the stent is routinely removed one week later.Is this stent placement an inherent part of performing the primary procedure, or is this a billable service? Thank you!PRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
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 it allowed????Everything I find online like AAPC says to bill both 52214 and 52001-59 but there is nothing recent and nothing concrete about what is considered distinct. I mean using a clot evacuator is different than using a loop electrode. Below are the Optum rationales.So the urologist does a cysto on hematuria work up, and they wind up using an evacuator to remove huge amounts of clot burden. Then use a loop electrode to fulgurate some areas that look suspicious.Why is that service not considered distinct? Compliance says its incidental but they can't tell me when it wouldn't be incidental and I don't want to let optum take back money without an argument.Hi, I would like to ask a coding question please. Thank you so much!For Robot-assisted left partial nephrectomy and Resection of a left renal hilar lymph node, Do we code any additional CPT to capture renal hilar lymph node, in addition to partial nephrectomy 50543?Pathology report had a separate report for Renal hilar lymph node dissection, which was negative for carcinoma. And for partial nephrectomy, path showed Renal cell carcinoma. PRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
August 16, 2024Mark, 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 of regional lymph nodes, and adrenalectomy). I recall reading a PRS article regarding what constitutes a a radical nephrectomy (of course, currently I can not find my reference). But if I recall correctly, the main criteria for radical is the removal of the Gerota's facia. The nodes, adrenal and fatty tissue were not the determining factor, and did not have to be removed to classify as radical 50545. Can y'all please help direct me to the correct understanding? Does the adrenal gland have to be removed in a radical nephrectomy? Thanks for any input y'all can provide. The CPT book does not define limited vs complete for penile duplex scans the way it does for other vascular studies. How do we choose between 93980 and 93981, and what do we look for in documentation to determine whether it is complete or limited If it is not a follow up? I have never had a provider perform this procedure before and want to make sure i am understanding the codes correctly. Thank you! AMA Paranthetical Linkhttps://cpt-international.ama-assn.org/cpt-implementation-guide-component-2-primerPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUsThe Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
August 9, 2024Mark and Scott discuss the 2025 Proposed CMS Rules. PRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
August 2, 2024Mark, 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 eliminates the need for a separate Reservoir. Are we coding with 54405-52? VS no modifier 52? Thank you!EmanoFlowHello all,I see there is a podcast on this topic from April 2022. I was hoping there may be some updates on coding and/or information.One of our doctors has started using EmanoFlow. There is no device for this app. We realize there can only be one billed per calendar date with 51741-26If the doctor reads the uroflows as they are done and creates encounters with documentation of his review, for each day the patient completes the uroflow, is it correct to assume that the doctor can bill for each one?Also does anyone have experience on what the financial responsibility is to patients? The rep was very vague on patient responsibility. I'm assuming (never the best idea) that it is just based on the clinics fee schedule for uroflows with a 26 on them.Hi, I have a question regarding coding for psoas-hitch with laparoscopic approach. Should these be coded with unlisted 50949 and bench marked to 50785 or does 50948 include the psoas-hitch? PRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
July 26, 2024Scott, 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 contributions to influence healthcare policies. The conversation highlights how unified efforts and innovative solutions can transform the medical profession and improve health outcomes nationwide. Urology Advanced Coding and Reimbursement VIRTUAL SEMINARRegister Now for the Urology Advanced Codingand Reimbursement Virtual SeminarJoin 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 ease.Special Early Bird Discount Code: 24UACRVE7Click Here for Information and RegistrationPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
July 19, 2024Scott, 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 private insurance requirements efficiently, focusing on setting up internal processes to safeguard against common billing errors and ensure compliance. Urology Advanced Coding and Reimbursement VIRTUAL SEMINARRegister Now for the Urology Advanced Codingand Reimbursement Virtual SeminarJoin 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 ease.Special Early Bird Discount Code: 24UACRVE7Click Here for Information and RegistrationPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
July 12, 2024Scott, 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 MRIfusion biopsy is done with the transperineal approach. Is that OK? Kimberly:Can someone please explain to me if codes 52214 and 52224 can be billed together? If yes, whatmodifier are you using? Also, how is code 52224 a component of 52214??? These codes blow mymind!!!Urology Advanced Coding and Reimbursement VIRTUAL SEMINARRegister Now for the Urology Advanced Codingand Reimbursement Virtual SeminarJoin 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 ease.Special Early Bird Discount Code: 24UACRVE7Click Here for Information and RegistrationPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
June 28, 2024Scott, 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 on telehealth adoption, legislative efforts to sustain telehealth services, and the strategic role of advocacy in urology. Dr. Rhee also touches on his potential candidacy for the AUA Presidency and emphasizes the significance of grassroots involvement in policy-making.Urology Advanced Coding and Reimbursement VIRTUAL SEMINARRegister Now for the Urology Advanced Codingand Reimbursement Virtual SeminarJoin 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 ease.Special Early Bird Discount Code: 24UACRVE7Click Here for Information and RegistrationPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
June 21, 2024Mark, 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 SEMINARRegister Now for the Urology Advanced Codingand Reimbursement Virtual SeminarJoin 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 ease.Special Early Bird Discount Code: 24UACRVE7Click Here for Information and RegistrationPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
June 14, 2024Mark, 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. Aside from the results, going over a treatment plan could be a billable event. Truly depends on what you are using this visit for. I have added an AMA sheet that will help with the different scenarios.Please let me know your thoughts Ordering a test is included in the category of test result(s) and the review of the test result is part of the encounter and not a subsequent encounter.”And, from the CPT Assistant, (AMA publication) November, 2020, page 5: “It is assumed that the physician or other QHP would review the results of the test ordered; therefore, the physician or other QHP would not receive dual credit toward MDM for service-level selection for both ordering and reviewing the test.” Hi, a question please. Thank so much.For Robotic assisted retroperitoneal lymph node dissection, Lap Resection of right gonadal vein/Spermatic cord stump. I coded Robotic assisted retroperitoneal lymph node dissection with 38589 (benchmarked to 38780),but I have a question for Lap Resection of right gonadal vein/Spermatic cord stump,Should these be coded with two CPT codes: One to capture right gonadal vein resection and another one to capture Spermatic cord stump? VS these two are on the same location and should only be coded with one CPT code? Thank you! Urology Advanced Coding and Reimbursement VIRTUAL SEMINARRegister Now for the Urology Advanced Codingand Reimbursement Virtual SeminarJoin 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 ease.Special Early Bird Discount Code: 24UACRVE7Click Here for Information and RegistrationPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
June 7, 2024Mark 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 Medicare billable service?Is cystoscopy a moderate risk (level 4) procedure for medical decision making purposes absent other risk factors? Does it matter for MDM risk what discussion or thought process is documented? Or would that only be toward the medical necessity of the procedure?CPT code 55250 says it is including postoperative semen examinations. So far we have done these in house but my physicians would like to no longer perform those and are currently looking into purchasing FELLOW kits to sell to the patients. We do not have any labs in town that perform post vas semen analysis. Any advice on what to do when patients refuse to purchase the kit?If Trimix is a compounded drug wouldn't J7999 - Compounded drug, not otherwise classified be more appropriate to vs J3490? Urology Advanced Coding and Reimbursement VIRTUAL SEMINARRegister Now for the Urology Advanced Codingand Reimbursement Virtual SeminarJoin 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 ease.Special Early Bird Discount Code: 24UACRVE7Click Here for Information and RegistrationPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
May 31, 2024Mark and Scott welcome Marianne Desciose to discuss what are the biggest issues right now in RCM. Urology Advanced Coding and Reimbursement VIRTUAL SEMINARRegister Now for the Urology Advanced Codingand Reimbursement Virtual SeminarJoin 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 ease.Special Early Bird Discount Code: 24UACRVE7Click Here for Information and RegistrationPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
May 24, 2024Mark, 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 SEMINARRegister Now for the Urology Advanced Codingand Reimbursement Virtual SeminarJoin 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 ease.Special Early Bird Discount Code: 24UACRVE7Click Here for Information and RegistrationPRS Billing and Other ServicesClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarSpecial Early Bird code: 25UACRS732 Click Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
May 17, 2024Mark, 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 units for 87798 for UTI PCR and Rectal swab PCR?Would charging 87801 be better for rectal swab PCR? VS 87798Urology Advanced Coding and Reimbursement VIRTUAL SEMINARRegister Now for the Urology Advanced Codingand Reimbursement Virtual SeminarJoin 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 ease.Special Early Bird Discount Code: 24UACRVE7Click Here for Information and RegistrationPRS Billing and Other ServicesClick Here to Get More Information and Request a Quote The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
May 10, 2024Mark and Scott discuss FAQs that came into the Urology Coding and Reimbursement Group.MRI fusion biopsy updateHi,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 - we know that Medicare requires a physician to be onsite, does this also apply to commercial payers?Hi, a question regarding NCCI edit pls. When unbundling is not allowed between two CPT, due to an indicator "0", never billed together. If the secondary CPT has more work-RVU than primary CPT, i.e. 51705 (primary) wRVU 0.9; and 52000 (secondary) wRVU 1.53, Are there any rules that we must bill Primary 51705? VS Can we choose to bill 52000 instead, knowing that 52000 has more wRVU than 51705? Thank you, Urology Advanced Coding and Reimbursement VIRTUAL SEMINARRegister Now for the Urology Advanced Codingand Reimbursement Virtual SeminarJoin 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 ease.Click Here for Information and RegistrationPRS Billing and Other ServicesClick Here to Get More Information and Request a Quote The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
April 26, 2024Ray, 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 APPsDocumentation 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%Certification for Urology CodersDocumentation, Coding, and Billing Certification Course for Urology CodersUse Special Discount Code: DCBSC5624 and Save 36%PRS Billing and Other ServicesClick Here to Get More Information and Request a Quote The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
Dr. Tom Curran interviews Composer Eric Genuis about the positive (and negative) impact of music and his ministry of bringing beautiful music to schools, churches, cities and prisons. Get More Information about the Eric Genuis Benefit Concert for Chesterton Academy!
April 19, 2024Ray, 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 APPsDocumentation 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%Certification for Urology CodersDocumentation, Coding, and Billing Certification Course for Urology CodersUse Special Discount Code: DCBSC5624 and Save 36%PRS Billing and Other ServicesClick Here to Get More Information and Request a Quote The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
April 12, 2024Mark 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 51700 be coded or just 51702? Should it matter if pass its fail? The service was still performed. And the 51702 is a component of the 51700.What are the codes that I use for gemcitibine bladder installation in the office. I know I would use 51720 would be the cpt code but how do i bill for the medicine?For Scrotoplasty, complicated (CPT 55180), Does it need to be performed with either Graft of Flap, to call for "complicated"? I am trying to differentiate between 55175 (scrotoplasty, simple) and 55180 (scrotoplasty, complicated), thank you! New Courses Available for Urologists and Urology APPsDocumentation 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%Certification for Urology CodersDocumentation, Coding, and Billing Certification Course for Urology CodersUse Special Discount Code: DCBSC5624 and Save 36%PRS Billing and Other ServicesClick Here to Get More Information and Request a Quote The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
April 5, 2024Mark, 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 critical role of Advanced Practice Providers (APPs) in urology, their billing nuances, and the necessity of continuous education to ensure financial health and combat provider burnout. The discussion wraps up with insights into the evolving landscape of medical coding and billing, stressing on AI's role in audits and the need for precise documentation. Links to further details about the courses can be found below. New Courses AvailableDocumentation for Reimbursement Challenge for Urologists Use Special Discount Code: DRC4824 and Save 36% Documentation for Coding and Reimbursement for APPs Use Special Discount Code: DCRA4824 and Save 36%Certification for Urology CodersDocumentation, Coding, and Billing Certification Course for Urology CodersPRS Billing and Other ServicesClick Here to Get More Information and Request a Quote The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com
March 28, 2024Mark, 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 ServicesClick Here to Get More Information and Request a Quote The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 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 Trial of AUACodingToday.com