Mark Painter is CEO of PRS Urology SC in Denver.
TURP reimbursement denied due to misinterpretation of parenthetical attached to code
July 8th 2021"Depending on the age of the surgeon, one may be surprised to hear that it was common to perform a vasectomy routinely on patients undergoing a TURP procedure," write Jonathan Rubenstein, MD, and Mark Painter.
What are the reimbursement implications when a patient brings their own catheter?
July 5th 2021"It is clear that if a practice were to require or encourage all or some of their patients to supply their own catheters, it would be considered a violation of your Medicare participation and could result in takebacks, fines, or even exclusion from Medicare," write Jonathan Rubenstein, MD, and Mark Painter.
Why CPT 38571 plus modifier 52 is recommended in this RALP case
May 25th 2021"Either way the service is reported, the payer should require documentation be submitted for review prior to payment, and the use of the –52 on the 38571 will provide more appropriate guidance for reimbursement processing," write Jonathan Rubenstein, MD, and Mark Painter.
Is it appropriate to bill 51700 for urinary retention 2 weeks after TURP?
March 24th 2021"Placing a catheter to irrigate obstructing blood clots (CPT 51700) is specifically included in the payment for the TURP if this complication is managed outside of an operating room," write Jonathan Rubenstein, MD, and Mark Painter.
Urology coding Q&A: Is CPT code 99072 being paid?
February 1st 2021"Unfortunately, we have found that most if not all insurers do not pay for this code and additionally often have policies against charging patients for extra supplies, and balance billing would be a violation of their contract," write Jonathan Rubenstein, MD, and Mark Painter.