Post-ESWL obstruction: How to code for new stent
February 12, 2020
"First... you have to determine if you are in a global period," write Jonathan Rubenstein, MD, and Mark Painter.
Mark Painter
What are Category III codes, and how are they best used for billing?
January 31, 2020
"Category III codes are designated as temporary codes by the AMA. Even though the codes are considered temporary, they are an integral and important part of the system," write Jonathan Rubenstein, MD, and Mark Painter.
When do I need to start consulting a clinical decision support mechanism?
January 17, 2020
Jonathan Rubenstein, MD, and Mark Painter address the coding question: My local hospital tells me that starting Jan. 1, 2020, I have to consult a Clinical Decision Support Mechanism due to the Appropriate Use Criteria program. I thought that didn’t start until 2021. Can you help?
Biofeedback training code deleted, replaced with time-based codes
January 3, 2020
"By creating time-based codes, one can most accurately describe and be reimbursed for the amount of time and effort spent face to face with an individual patient," writes Jonathan Rubenstein, MD, and Mark Painter.
2020 final rule reveals small gains for urology reimbursement
December 5, 2019
Urology will make a modest gain overall in the 2020 final rule for the Medicare Physician Fee Schedule, although the truly significant changes won’t be felt until 2021.
Cystoscopy plus patient discussion: Can –25 modifier be used?
November 25, 2019
"If the specific time spent discussing the disease and the appropriate treatment was not documented, then be sure that your documentation meets the criteria (history, physical examination, and medical decision-making) separate from any criteria performed to make sure the patient was prepared and able to have the procedure," write the Painters.
ICD-10/CPT updates involve coding for strictures, orchiopexy
November 13, 2019
"One of the common issues we have noted for urology practices in updating ICD-10 codes is not the electronic medical record or practice management system failing to load new codes; rather, it is a failure to update templates," write Ray Painter, MD, and Mark Painter.
Can I charge for different stone procedures in the same kidney?
October 25, 2019
Documentation must support performance of ‘unusual services,’ according to Ray Painter, MD, and Mark Painter.
Hospital refuses access to EOBs; what can I do?
October 14, 2019
"There are two major reasons for you to confirm accuracy: to be sure that fraudulent claims are not being submitted and to confirm that the claims accurately reflect the work you have performed," write Ray Painter, MD, and Mark Painter.
Proposed rule: Look for changes to MIPS, supervision of APPs
September 16, 2019
"The much-anticipated proposed rule for the Medicare physician fee schedule was finally released on July 29, 2019. The bottom-line impact to urology for 2020-based changes to relative value units is a projected +1% additionally," write the Painters.
