Top 10 urologic coding stories in 2023

There’s been an abundance of news surrounding coding in urology over the last year. In honor of these breakthroughs, Urology Times® is highlighting our top content on urologic coding from 2023.

2024 Medicare final rule: Here comes code G2211

The Centers for Medicare & Medicaid Services unveiled the final rule for the Medicare Physician Fee Schedule for 2024 on November 2, 2023. Experts discuss those changes most relevant to urology, as well as some clarification on the final rules announced. Read their discussion here.

CMS final rule increases payment rate for iTind procedure in HOPD and ASC

The 2023 CMS final rule included increased payment rates for code C9769 covering the iTind procedure in hospital-based outpatient department (HOPD) and ambulatory surgical center (ASC) facilities. The CMS CY2023 Outpatient Prospective Payment System Rule was finalized and announced on November 1, 2022, and the rates went into effect January 1, 2023. Read more here.

Current Procedural Terminology code urology updates for 2024

In October 2023, the Current Procedural Terminology (CPT) for 2024 was released. Experts highlights changes to the CPT code set for urology, which will take effect on January 1, 2024, for all payers. Read more here.

Clearing up confusion surrounding percutaneous nephrolithotomy coding

Jonathan Rubenstein, MD, and Mark Painter discuss how to bill for percutaneous nephrolithotomy using the updated CPT codes 50080 and 50081. Learn more here.

New for 2023: Laparoscopic simple prostatectomy code 55867

In an interview with Urology Times, Jonathan Rubenstein, MD, discussed the new laparoscopic simple prostatectomy code CPT 55867. Rubenstein is compliance officer and medical director of coding and reimbursement at United Urology Group and Chesapeake Urology in Towson, Maryland. Watch here.

Billing for lithotripsy of upper ureter stones followed by URS in the kidney

Jonathan Rubenstein, MD, and Mark Painter discuss reporting for a scenario involving lithotripsy of upper ureter stones followed by ureteroscopy in the kidney. Read here.

CPT code X170T issued for low-intensity extracorporeal shock wave therapy

In July 2023, The American Medical Association issued Current Procedural Terminology code X170T for low-intensity extracorporeal shock wave therapy (Li-ESWT) for the treatment of men with erectile dysfunction. Urologists and other medical professionals can begin using the code on January 1, 2024, to facilitate the reimbursement of Li-ESWT involving the corpus cavernosum. Read more here.

How to bill for PCNL using existing and new access

Experts discuss billing for a PCNL that involves going through the lower pole (existing access) as well as creating and dilating a new access through the upper pole. Read more here.

Billing for nephroscopy with ureteroscopy and laser lithotripsy

"CPT codes 50080 and 50081 describe the antegrade approach to stone removal requiring lithotripsy through a nephrostomy tract, with 50080 being reported for stones less than 2 cm in size in a single location, whereas 50081 would be reported for large or complex stones, stones in multiple locations, or stones in the ureter (such as in the example provided)," write Jonathan Rubenstein, MD, and Mark Painter. Read more here.

Using modifier –25 on an E/M visit: Is it worth it?

Modifier -25 is defined as a significant, separately identifiable E/M service by the same physician or other qualified health care professional on the same day of the procedure or other service. Experts discuss its administrative burden, but conclude, “In the long run, it is our opinion that modifier -25 is worth the battle.” Read more here.

You can view all of our coding content, and other stories in practice management, here.