Urology Coding and Reimbursement Podcast
The Urology Coding and Reimbursement Podcast is for Urologists and urology practice staff: Administrators, APPs, Billers and Coders. We help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life. Your cohosts, Mark, Scott and Dr. Ray Painter discuss urology coding and share best practices for the urology office. We will answer submitted urology coding questions so that you can learn the concepts and apply in your practice. Learn the best practices: urology coding, revenue cycle management, scheduling, collections, patient information collection, pre-authorization, prior approval, charge capture, office communications, claim entry review, appeals, audits and billing, that we have tested and proven so you can adapt and incorporate.
Urology Coding and Reimbursement Podcast
UCR 184: FAQs - Clarification of split shared visit, and cystoscopy, dilation, and clot evacuation coding
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Episode 184
February 23, 2024
Mark, Scott, and Ray discuss questions that came into the PRS Network:
- Regarding the most recent podcast episode on shard/split visits: Medicare's policy states that only one practitioner must have face-to-face time with the patient. In our practice the physician documents an addendum on the APP's note with the medical decision making portion of the visit. Per the episode, the physician must demonstrate involvement during the visit (not afterwards) in order to bill under the physician's NPI. Is there a guideline that states the physician must document their portion in real-time as the visit with the APP takes place? If they document the MDM portion of the visit in its entirety, isn't that enough to bill for the "substantive portion of MDM" as required by Medicare?
- For 52001, we commonly use this code for cysto and clot evacuation for gross hematuria under general anesthesia requiring rigid scope. Are physicians allowed to use this code for cystoscopy and irrigation of a clot with a syringe under local procedure or should they use 52000 + 57000?
- For 52281, does passage of the cystoscopy to dilate a narrowing in the urethra or meatus count? Or it is only meant to be used for cases where the meatus is cut or dilators or DVIU are used?
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