Practice Management

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Washington-The results of this month's presidential and congressional elections will go a long way toward determining the fate of efforts to curb medical liability lawsuits and judgments, as well as the related issue of protecting patient safety.

Three separate coding and reimbursement issues are impacting urologists now and will continue to affect practices in 2005. This article will focus on these three issues-ICD-9 changes for 2005, drugs purchased by physicians, and the -59 modifier.

Bladder ultrasound is noninvasive and relatively easy to perform, which may explain its increased usage in recent years. However, the American Board of Urology has expressed concern that urologists may be overusing the test. In this exclusive Urology Times interview, Pat Fulgham, MD, president of Urology Clinics of North Texas, Dallas, discusses data on the dramatic shift in bladder ultrasound usage by some urologists. Dr. Fulgham, who teaches an annual AUA course on ultrasound, also discusses clinical and reimbursement guidelines clinicians should follow. The interview was conducted by UT Editorial Consultant Robert C. Flanigan, MD, professor and chairman of the department of urology, Loyola University Medical Center, Maywood, IL.

Washington--Even though the new Medicare physician fee schedule rule increases physician payments by 1.5% overall for Medicare services, urologists are facing a 13% reduction, according to AUA officials.

Q A pediatric urologist I code for is concerned that we cannot bill/code for both orchiopexy and a hernia repair done during the same operating room session. Do you have any documentation on this matter? When you look up 54640 in CPT 2004, it references, "For inguinal hernia repair performed in conjunction with inguinal orchiopexy, see 49495-49525." In the Medicare Correct Coding Guidelines, I do not see any edits stating not to bill both procedures together.

The American Medical Association has updated its Model Managed Care Contract to reflect recent legal and other changes. New portions of the model contract, now in its third edition, address changes in medical necessity, HIPAA regulations, and prompt payment.

Minnetonka, MN-The FDA has cleared for marketing American Medical Systems' 700 Tactile Pump, the latest addition to the AMS 700 line of penile prostheses.

Minnetonka, MN-The FDA has cleared for marketing American Medical Systems' 700 Tactile Pump, the latest addition to the AMS 700 line of penile prostheses.