August 8th 2025
"It is common for a payer to request patient records when submitting for a service with a category III code," 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.
Is your urology practice prepared for evaluation/management coding changes in 2021?
November 2nd 2020“It’s going to be a slow process for hospitals to give the proper information to their physicians so that when we’re moving on to the new coding system, we’re not doing extra work," says one urologist.