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.