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.
Episodes
- June 6, 2025
In this episode, Ray, Mark, and Scott welcome back Dr. John Lin to discuss topics brought up on the Thriving Urology Practice Facebook Group.
1) Just got a call from ER. 19 year-old cannot get an erection...
2) This notice came from the hospital last week regarding change in financial protocol about scheduled / elective surgical procedures.
Increased Patient Responsibility:
As is customary in the Phoenix mark...
May 30, 2025
In this episode, Mark and Scott address upcoming significant changes to the prostate biopsy codes and provide guidance on correctly applying modifiers 25 and 59 when billing procedure 51798 and an E/M service. They also discuss coding considerations for the emerging practice of robotic-assisted vasectomies.
PRS Coding and Reimbursement Hub
May 23, 2025
Scott, Mark, and Ray answer listener questions on coding for remote uroflowmetry, defining high-complexity MDM, and dealing with low Medicare Advantage reimbursements. They discuss CPT code options, provide examples of immediate-risk diagnoses, and offer strategies for contract negotiations.
PRS Coding and Reimbursement Hub
May 16, 2025
Scott and Mark switch roles to introduce the new PRS Coding and Reimbursement Hub, featuring Jelmyto as an example. The Hub helps practices simplify workflow, coding, and reimbursement processes. Scott explains how the Hub provides clear, trusted guidance, enabling urology practices to streamline reimbursement, reduce confusion, and accelerate patient access.
PRS Coding and Reimbursement Hub
May 9, 2025
In this episode, Scott, Mark, and Ray answer questions that came into the PRS Helpdesk.
- One of my specialties is pedsurology and there is just not much guidance for surgery coding.
Is it appropriate to use 54360 (plastic operation on penis to correct angulation) for correction of penile torsion?
I found an article from AAPC dated 2005 that stated to use 14040 for penile torsion repair when performed...
May 2, 2025
In this episode, Scott, Mark, and Ray share highlights from the AUA 2025 Annual Meeting in Las Vegas, discussing exciting new technologies, reimbursement challenges, key conversations, and updates from the urology community.
Free Kidney Stone Coding Calculator
PRS Billing and Other Services - Book a Call with Mark Painter or
Marianne Desciose
Click Here to Get More Information and Request a Quote
...
April 25, 2025
Scott, Mark, and Ray discuss the pressures of Urology practice in 2025. They talk about what you need to be aware of and why you need to plan for the future.
Free Kidney Stone Coding Calculator
PRS Billing and Other Services - Book a Call with Mark Painter or
Marianne Desciose
Click Here to Get More Information and Request a Quote
Join the Urology Pharma and Tech Pioneer Group
Em...
April 18, 2025
Scott, Mark, and Ray discuss questions that came into the PRS Helpdesk:
- For the past 8 months, I have been in an employed position with a county hospital system that provides inpatient and ambulatory services. Their coding consultants (acsteam.net) are telling the hospital that foley catheter insertions, bladder irrigations, and a list of other procedures commonly performed in urology clinics cannot be b...
April 11, 2025
Scott and Mark discuss questions that came into the PRS Helpdesk:
- Hello, Some years ago we were using the SRS urocuff. Can you tell me what the current codes are? I know this has been mentioned at the seminars- cannot find the slide :( Thanks
- How are groups coding for the new Revi procedure for urge incontinence, urgency of urination, for both professional and facility fees. Is it best to use a 0817T or a...
April 4, 2025
Scott and Mark discuss who can perform biofeedback services, clarify billing requirements, and explore practical scenarios involving incident-to billing. Mark and Scott break down key Medicare guidelines, share best practices for documentation, and offer tips for optimizing biofeedback delivery within your urology practice.
Free Kidney Stone Coding Calculator
PRS Billing and Other Services - Book a...
March 28, 2025
Scott, Mark, and Dr. Ray Painter discuss questions that came into the PRS Helpdesk.
- NGS sent a newsletter about the use of: cpt code G0463 as a primary code for G2211. Need more info if possible.
- Do nurse practitioners get paid at 100% for procedures like a PNE when signing notes in NM by themselves?
- a) Medicare NGS is denying CPT 52332 for bilateral stents with denial CO-151. This seems to be a constant...
March 21, 2025
Scott, Mark, and Dr. Ray Painter break down the latest developments in telehealth policy and Medicare reimbursement. Mark shares the good news about the extension of telehealth flexibilities and the bad news regarding the unchanged (and still reduced) conversion factor. They also dive deep into the recent uptick in RAC audits, highlighting the procedures being targeted, documentation pitfalls to avoid, and ...
March 14, 2025
Scott, Mark, and Ray discuss three coding questions from the PRS Community and the Thriving Urology Practice Facebook group.
- My question is regarding G2211. Is there a time frame for the follow-up that needs to be dictated. My doctor has been putting return to clinic in a year in the notes and billing G2211. Wondering if this is ok, or if the follow up must be sooner?
- Our new urologist started placing a...
March 7, 2025
Scott, Mark, and Ray discuss the latest updates (or lack thereof) on telehealth policies as the current extension nears expiration. They break down what practices should consider when scheduling telehealth visits, the potential impact of congressional actions, and how to prepare for possible changes.
The second topic dives into specialty designations within the same practice—what happens when different taxono...
February 28, 2025
Scott, Mark, and Dr. Ray Painter break down the challenges of securing fair compensation for extra work performed in urology procedures when using modifier 22, unlisted codes, or Category III codes. They discuss effective strategies for communicating with payers and contract administrators, ensuring proper documentation, and negotiating fair work RVU adjustments.
Free Kidney Stone Coding Calculator
February 21, 2025
Scott and Mark discuss questions from the PRS Network Community and the Thriving Urology Practice Facebook group.
- Does anyone bill out a removal of testicular appendix separately from the hydrocelectomy? I have a new physician that is submitting 55040 and 54512.
- After presenting Grand Rounds on billing/coding the question arose that our billing department is billing g G2211 with a modifier 25 and getti...
February 14, 2025
Scott, Mark, and Ray discuss questions that came into the PRS Network Community.
- Our doctor's occasionally use the ESWL (Extracorporeal Shock Wave Lithotripsy) for bladder stones. Insurance requires a laterality modifier. I am not sure if we can bill for it or not. If we can bill for it, what is the correct way to do it?
- Can you please clarify the relaxation of the in person requirement for super...
February 7, 2025
Scott and Mark welcome back Dr. John Lin and Marianne Descoise to discuss some key takeaways from the Urology Advanced Coding and Reimbursement Seminar, which took place in New Orleans from January 31st to February 1st.
Free Kidney Stone Coding Calculator
PRS Billing and Other Services - Book a Call with Mark Painter or
Marianne Desciose
UCR 228: G0559 clarification, GC Modifier Explained, and G2211 documentation suggestion.
January 24, 2025
Scott, Mark, and Dr. Ray Painter address questions submitted to the PRS Network.
- I recently attended your Billing and Coding conference in Las Vegas this past December.
I need clarification on New CPT code G0559, can someone please contact me as soon as possible. - From a coding perspective, I ...
January 17, 2025
Scott, Mark, and Dr. Ray Painter are joined by special guest Marianne Desois, COO of PRS Managed Services, to dive into the growing issue of payer recoupments. They discuss the tactics payers use, common pitfalls practices face, and actionable strategies to identify and appeal recoupments effectively, helping you safeguard your revenue stream.
Free Kidney Stone Coding Calculator
Urolog...
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