Practice Management

"The mean and median MIPS final composite scores among urologists in 2017 were 79.3 and 91.2, respectively; this was slightly higher than all specialties combined," writes Robert A. Dowling, MD.

I wanted to take this opportunity to say thank you to all who have read my “Coding and Reimbursement” and “Coding Q&A” articles for the past 23 years.

"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.

"If you are self-employed, a solo 401(k) is an excellent option for saving for retirement," writes Jeff Witz, CFP.

“It’s actually an exciting time for patients who have metastatic urothelial cancers and prostate cancers or advanced prostate cancers because there are a lot more products on the way, like the newer hormone agents for prostate cancer and the new immunologic agents like PARP inhibitors for different types of cancers," says one urologist.

Declining reimbursement for their work and the burden of prior authorization are nearly universal concerns of U.S. urologists, an exclusive Urology Times survey has found.

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.

"Becoming a member of the larger group has given us more bargaining power in the health care marketplace, so we’ve been able to get better health care, not only for us but for our staff," says one urologist.

"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.

"On Nov. 1, 2019, CMS published a final rule making important changes to the 2020 Quality Payment Program (Merit-based incentive Payment System [MIPS] and alternative payment models). Among the most significant are changes to the MIPS Cost Category: changes in the way patients are attributed to physicians, changes in the way the cost measures are calculated, and the addition of new episode-based cost measures," writes Robert A. Dowling, MD.

Avenues for taking distributions vary according to the decedent’s age.

"Automated urinalysis codes declined 19%, while the manual urinalysis codes without and with microscopy dropped 0.6% and 7.6% respectively over the 3-year period," writes Robert A. Dowling, MD.

"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.

In this video, Mara R. Holton, MD, vice chair of LUGPA’s Health Policy Committee, discusses how the 2020 Medicare Physician Fee Schedule Final Rule will affect urologists.

"This time of year presents the perfect opportunity to review and possibly adjust your financial planning strategies," writes Jeff Witz, CFP.

"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.

This article will discuss obstacles that urologists typically must address when implementing telemedicine into their practice.

Written policies should address scheduling guidelines and appointment cancellations, advises Robert A. Dowling, MD.

"If your life insurance needs are temporary, then term insurance is likely the most appropriate vehicle," writes Jeff Witz, CFP.

"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.

"One is the delay in delivering care. If I order surgery that requires prior authorization, it won’t always come through in a timely manner, and that impacts patients’ quality of life," says one urologist.

"Patient access to health information-whether it resides in a medical record, a lab company’s system, or an insurance company records-is a right firmly protected by federal laws and regulations," writes Robert A. Dowling, MD.

Trusts provide management of assets while minimizing probate expenses, according to Jeff Witz, CFP.

"Respecting what we believe is the intention of the CPT description, if the hernia repair is incidental, we will recommend not coding for the hernia repair," write the Painters.

Detailed consent statements are recommended, even for repeated treatments.