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

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Jelmyto Coding and Reimbursement Page

Upper Track Urothelial Cancer (UTUC) Coding and Reimbursement Page

Free Kidney Stone Coding Calculator

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PRS Billing and Other Services - Book a Call with Mark Painter or
Marianne Desciose

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Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

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The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

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

Access the Hub

Jelmyto Coding and Reimbursement Page

Upper Track Urothelial Cancer (UTUC) Coding and Reimbursement Page

Free Kidney Stone Coding Calculator

Download Now

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

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

May 9, 2025

In this episode, Scott, Mark, and Ray answer questions that came into the PRS Helpdesk.

1. 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 with a MAGPI hypospadias repair (54322).
   What if the penile torsion repair is not performed with another procedure or at least without a hypospadias repair?
2. If Medical technologists (Medical assistants trained to perform Urodynamics) can perform this test why are Medical assistants not permitted by CMS to perform catheter insertion and removal in non regulated sites of services? (I have seen MAs in non regulated spaces perform catheter changes, bladder instillations--etc---how are practices able to get away with having MAs incorporated in their work flow as such?)
3. In regulated sites of service (Hospital based clinics) what documentation should be used to ensure proper billing when an MA performs 51798 (bladder scan) (incident to billing for a hospital-employed physician).

Free Kidney Stone Coding Calculator

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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

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

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

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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

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

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

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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

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

April 18, 2025

Scott, Mark, and Ray discuss questions that came into the PRS Helpdesk:

1. 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 billed if they are not performed personally by the physician according to CMS. They reference a list of procedures from CMS and state that these services cannot be billed when performed by ancillary staff regardless of the level of supervision. They use https://www.cms.gov/status-indicators as their source citing the section on PC or TC indicators. Can this be true? Is it possible that this consultant is giving advice from a hospital perspective and not aware of differences between the ambulatory setting? The urology clinic I am working in is not a department of the hospital. It is freestanding. I have never worked in a clinic that did not bill for these services performed by ancillary staff with physician supervision.
2. I look forward to your response.
3. Good afternoon, my question is regarding "Incident to" required documentation. When we attended your seminar this past December, on Day 2, the new "Incident to Rule" was discuss. Can you please help clarify the new rule? My notes are not clear.
   We are in the process of CMS Review -"Targeted Probe and Educate Round 1". The letter states we were chosen for review because of being in the 60th percentile for our jurisdiction for code 99214.
   Our practice has the challenge of servicing and underprivilege community and estimated population of 590,142. We have 7 Urologist, 4 Apps and 1 Radiation Oncologist in our practice. Hence our volume is overwhelming.
   Earlier this year we submitted a batch of approximately forty records. Today we received a notification request "Incident to documentation: needed 2 previous office visits done by MD to support physician/supervising provider's initiation and continued involvement in treatment, and documentation to support direct supervision met.
   I appreciate any assistance with clarifying the “Incident to” rule.
   Thank you in advance for your assistance.
4. Doctor did a stent pull in the ASC but not with Cysto scope. How would we go about billing this?

Free Kidney Stone Coding Calculator

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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

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

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April 11, 2025

Scott and Mark discuss questions that came into the PRS Helpdesk:

1. 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
2. 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 64581 w/ crosswalk? Cannot find a lot of information about this. Any feedback or suggestions would be greatly appreciated!
3. I would like your thoughts about the use of Pelvic Floor rehab CPT code 91122 in a urology practice. The company UroVal Inc. is promoting this procedure for urologists to perform in the office setting.
4. E/M question pls. Thank you! For a follow up office visit, Pt has prostate cancer, and he is on "Active Surveillance". For Problem Component of E/M, would you consider pCA on Active Surveillance is a Moderate VS a Low-level problem? (as opposed to personal history of pCA - Watchful Waiting). I think it's a moderate level 4, but would like to hear your opinion, thank you!!

Free Kidney Stone Coding Calculator

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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

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

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

Download Now

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

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/