Top 10 urology coding stories in 2022
As the year comes to a close, we revisit some of this year’s top content on coding and reimbursement for urologic procedures.
Coding in urology is constantly evolving.In light of all that has occurred over the past year, Urology Times® is counting down the top pieces of content surrounding coding and reimbursement in urology in 2022.
10. Trends in coding audits and what physicians can expect
Two experts highlighted recent trends in medical audits and what physicians can expect with the US Centers for Medicare and Medicaid Services’ (CMS) changes in 2021 to the documentation of Evaluation and Management (E/M) codes. Read more.
9. Legislation relieves some of 2022 Medicare fee schedule burden
Due in part to pressure from associations and lobbying groups, Congress stepped in to help providers avoid some cuts with the passage of the Protecting Medicare and American Farmers from Sequester Cuts Act, which became law on December 10, 2021. Read more.
8. Is non–face-to-face care coordination reimbursable?
In this video, Shirley Lee, CRNP-FNP, MPH, explains how non–face-to-face care coordination is reimbursable. Watch now.
7. How do you bill for a 75-minute audio-only E/M visit?
"As for the case described of a 75-minute audio-only E/M visit, there has been no specific coding guidance provided by CPT," wrote Jonathan Rubenstein, MD, and Mark Painter. Read more.
6. Why can’t CPT 50436 and 50437 be used when performing percutaneous nephrolithotomy?
"For several reasons, the percutaneous nephrolithotomy codes needed to be revised, as the language of the descriptor and what was included and not included was confusing and ambiguous," wrote Jonathan Rubenstein, MD, and Mark Painter. Read more.
5. Laparoscopic simple prostatectomy code is coming
On January 1, the following CPT code will be active: 55867 (laparoscopy, surgical prostatectomy, simple subtotal [including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy], includes robotic assistance, when performed). Read more.
4. CPT code 64590 confirmed by CMS for eCoin tibial neurostimulator
The Centers for Medicare & Medicaid Services (CMS), Division of Outpatient Care, confirmed that CPT code 64590 applies to eCoin, a leadless tibial neurostimulator approved by the FDA for the treatment of urinary urge incontinence. Read more.
3. Breaking down the CMS 2023 final rule for urologists
"We once again note that even success in the efforts to avoid any payment decreases will be a failure in the long run as overhead continues to rise against flat reimbursement," wrote Jonathan Rubenstein, MD, and Mark Painter. Read more.
2. Urology Coding: Can N20.0 and N13.2 be billed on the same CPT line?
Experts discussed payer edits referencing ICD-10-CM guidelines such as “Excludes 1.” Read more.
1. Modifier 22 incentive found to decrease opioid prescriptions following vasectomies
Using administrative claims data, investigators analyzed the opioid prescriptions filled for vasectomies before and after the expansion of Blue Cross Blue Shield of Michigan's modifier 22 program. Read more.
Potential code for prior authorizations on AMA CPT Editorial Panel meeting agenda
March 28th 2024"Good public and economic policy must align costs, benefits, and incentives; currently, all costs are incurred by physician practices, and all financial savings and benefits from prior authorization accrue to health insurance plans, leading to perverse incentives,” says Alex Shteynshlyuger, MD.
How to code for removal of a bladder calculus via a Mitrofanoff
March 22nd 2024"Per CPT coding instructions, when procedures or services performed by physicians do not have a valid or descriptive CPT or Healthcare Common Procedure Coding System (HCPCS) code, the service should be reported using an unlisted code," write Jonathan Rubenstein, MD, and Mark Painter.
