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Instructions for coding for all Evaluation and Management (E&M) services have several elements in common. One should always base documentation and coding on the amount of work required to provide good patient care.

The paradigm for the medical management of benign prostatic hyperplasia has undergone a significant change during the past decade. Guided by new research, the approval of novel pharmaceutical and minimally invasive therapies, and the economics of health care financing, physicians have altered their approach to patient care in distinct ways.

Chicago-Resistance to drugs commonly used against uncomplicated urinary tract infections continues to grow, according to the results of a large North American study presented at the 43rd Interscience Conference on Antimicrobials and Chemotherapy.

Even after the tremendous victory won by the American Lithotripsy Society and the Urology Society of America last year in federal court, urologists still must be concerned with Stark II and the federal anti-kickback statute.

Baltimore-The American Foundation for Urologic Disease's Reproductive Health Council has developed a new patient brochure about the benefits and possible risks of testosterone replacement therapy (TRT).

Winston-Salem, NC--Some men may be more prone to prostate cancer because a variation in a specific gene makes them more susceptible to the harmful effects of cancer-causing agents, a new study shows.

Washington-The Department of Health and Human Services announced the Medicare premium, deductible, and coinsurance amounts to be paid by Medicare beneficiaries in 2004.

Salt Lake City--Prostate cancer researchers say they have developed methods to predict treatment failure in men undergoing radiation therapy that is more precise and specific than current American Society for Therapeutic Radiology and Oncology guidelines.

Salt Lake City--New research shows that men with clinically localized prostate cancer who are treated to high dose levels with three-dimensional conformal radiation therapy achieve long-term PSA relapse-free survival with minimal side effects.

Large-scale telephone-based management of eligible women with presumedcystitis is associated with low clinical recurrence rates and a very lowincidence of other gynecourologic diagnoses, according to a study by a largeHMO in California.

Scientists at Northwestern University have developed an ultra-sensitivetechnology based on gold nanoparticles and DNA that can detect PSA whenpresent at extremely low levels in the blood sample. The new protein-detectionmethod could be used to monitor prostate cancer patients following surgery,according to the researchers, whose findings are published in the Sept.26 issue of the journal Science (2003; 301:1884-6).

A 4-year screening interval was found adequate for detecting most cancersin a large European randomized trial of prostate cancer screening, accordingto a study in the Oct. 1 issue of the Journal of the National CancerInstitute (2003; 95:1462-6).

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Articles in this month's Urology Times deal with an issue of "timing"when determining the treatment of invasive transitional cell carcinoma ofthe bladder.

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Los Angeles-After a follow-up of almost 2 years, 70% of patients withstress urinary incontinence reported no repeat SUI after surgery with syntheticpolypropylene sling material, according to UCLA researchers.

Montreal, Quebec-The interval between transurethral resection of bladdertumor and radical cystectomy significantly influences 3-year disease recurrencerates in patients with transitional cell carcinoma of the bladder, saidresearchers from McGill University in Montreal.

Chicago-Neoadjuvant platinum-based chemotherapy is associatedwith a statistically significant improvement in the overall survival ofpatients with locally advanced bladder cancer, according to the resultsof a recent meta-analysis presented at the AUA annual meeting here. However,the treatment benefit is not strong enough to support a recommendation forusing neoadjuvant chemotherapy in this setting, said Amir Sherif, MD, PhD,speaking on behalf of the Nordic Cooperative Bladder Cancer Group.

Albuquerque, NM-A new outcome model of prostate cancer progression followingradical prostatectomy has demonstrated good correlation between the model'spredictions and actual patient data. A study using this model suggests thatmen benefit more from radical prostatectomy over watchful waiting, evenif residual disease remains after surgery.

Once-daily quinolone gains new urology indications: West Haven, CT-Bayer Pharmaceuticals has received FDA approval to market its once-daily, extended-release fluoroquinolone, ciprofloxacin (Cipro XR), for two new indications: complicated urinary tract infections and acute uncomplicated pyelonephritis.

Among urologic tumor markers, the discovery and application of prostate-specific antigen has established PSA as a vital tool for the early diagnosis, staging, and monitoring of men with prostate cancer.

Edinburgh, Scotland-When used by the same operators in a single center, shockwave lithotriptors of different power generators provide comparable results and have similar complication rates in the treatment of renal stones, urologists at a Scottish stone center reported at the AUA annual meeting.

Atlanta-Patients and physicians are winning the battle against prostate cancer, new data show. What's not so clear-cut, though, is the reason why.

Certain enzyme inhibitors may slow tumor formation within weeks and could lead to treatments that retard or prevent recurrences of cancers, researchers at UT Southwestern Medical Center at Dallas have discovered.

Age should not be a barrier to treatment for older men who are relatively healthy but have aggressive prostate cancer, say researchers with University Health Network, Toronto.

Older men's sperm is more likely to contain disease-causing genetic mutations, suggests an analysis of sperm from men of various ages by scientists from the McKusick-Nathans Institute for Genetic Medicine at Johns Hopkins University, Baltimore.

Texas patients and physicians scored a major victory when voters approved Proposition 12, a constitutional amendment that authorizes the legislature to determine limitations on non-economic damages in medical liability cases. The vote ratifies the state's recently enacted medical liability reforms.