Urology Billing and Coding Guidelines


Introduction:

It is difficult to locate qualified Urology Billing and Coding Guidelines, expensive to hire, and expensive to retrain them. CPC-certified urology coders on our team can process up to 25-30 surgical reports each day, and they are all well-trained. All procedural, modifier, and diagnostic coding problems are covered in our Urology specialty coding service, and our coders are trained to manage them. At every stage of the billing and coding process, HIPAA compliance is ensured. To avoid denials, our team conducts pre-authorization of the patient’s eligibility and benefits.

Urology Billing and Coding

Urology Billing and Coding

Codes for urological surgeries in CPT and ICD-10

In order to categorize Urology Billing and Coding Guidelines, organs such as kidneys, bladders, urinary tracts, and sexual organs are taken into consideration.

In the range of 50010 to 58294

  • Incision and biopsy are two of the most common types of surgeries in urology.
  • Excision
  • Transplantation
  • The introduction of the catheter
  • Laparoscopy
  • Urethrascopy, urethroscopy, cystourethroscopy, and other endoscopies
  • Repairs

Codes from the new ICD-10 system.

There are rules for using ICD-10 numbers to minimize insurance denials. The ICD-10 codes used by our coders for coding for urological surgeries are listed below.

  • C00 – D49 – Neoplasm
  • E00 – E89 – Endocrine, nutritional and metabolic diseases
  • N00-N99 – Diseases of the genitourinary system
  • Q50-Q56 – Congenital malformations of genital organs
  • R30-R39 – Symptoms and signs involving the genitourinary system

Coding Practices for Urology

Pre-approval is required. An insurance company’s prior authorization is required for Urology operations because of the high cost of the procedures. A company can better comply with claim submission requirements and avoid denials by using Prior Authorization.

  • Medical Obligation. The medical necessity of treatment should be able to be justified by a urology service provider in order to charge appropriately for the expensive services they provide.
  • Denials of eligibility and benefits. Denials can be minimized by checking a patient’s eligibility and benefits for a certain service at least 48 hours beforehand.
  • CLIA number is invalid or missing (Clinical Laboratory Improvement Amendments). When the lab test is billed, the CLIA number should be revised.
  • Those services are not covered by Medicare, which classifies them as “Non-Covered Services” and refuses to pay for them. However, non-Medicare-covered services can be reimbursed by supplemental insurance.
  • Coding for the greatest possible gain. Codes for certain CPTs should use the correct units allowed by the payers. If we bill for more than one unit, Payers will reject CPT codes 51700, 52300, 52310, 55876, and 77263.
  • Information from the patient’s medical record in CPT codes 51701-51703. There is no need for code providers to record procedures 51701-51703 in addition to any other procedure that involves the placement of a catheter.
  • In order to properly bill for two urological procedures, providers must use modifier 59.
  • LCD Rules of Conduct. Before charging for Urology services, providers should adhere to LCD rules.

Compliance with medical coding standards.

Medical coding is one of our specialties, and we’ve built a solid name for ourselves in this field. In most cases, medical billing begins with accurate and thorough recording in the patient’s medical records. Since your intellectual services and effort are translated into a code, coding is the process through which insurance companies bill for your services and document their value.

Urology Billing and Coding Guidelines

Urology Billing and Coding Guidelines

The ICD-10 codes, in particular, are worth mentioning. In morbidity contexts, ICD-10 codes are used to categorize diseases, injuries, health encounters, and hospital operations. As a result, we’ve developed medical coding expertise and business processes to better serve solo practitioners.

Since the primary goal of medical coding is to provide universal numerical codes for use in insurance claims, a doctor’s narrative account of a patient’s illness, injury, or surgery is transformed into codes.

Because of this, our team of experienced medical coders ensures that services are properly aligned with a medical diagnosis in order to maximize compensation. As a result, this does more than ensure that the right amount is paid. Denials stemming from inaccurate diagnostic and procedure coding will also be reduced.