June 14, 2024

Mark, Scott, and Ray discuss topics that came into the PRS communities.

1. Can you bring this back up again as it relates to Audio only calls. Question i have is if you are just reviewing results that were ordered during a visit, this is essentially not a billable event. Isnt it considered double dipping because the review of the results and test order is included when ordered. Aside from the results, going over a treatment plan could be a billable event. Truly depends on what you are using this visit for. I have added an AMA sheet that will help with the different scenarios.
2. Please let me know your thoughts
3. Ordering a test is included in the category of test result(s) and the review of the test result is part of the encounter and not a subsequent encounter.”
   And, from the CPT Assistant, (AMA publication) November, 2020, page 5: “It is assumed that the physician or other QHP would review the results of the test ordered; therefore, the physician or other QHP would not receive dual credit toward MDM for service-level selection for both ordering and reviewing the test.”
5. Hi, a question please. Thank so much.
6. For Robotic assisted retroperitoneal lymph node dissection, Lap Resection of right gonadal vein/Spermatic cord stump.
7. I coded Robotic assisted retroperitoneal lymph node dissection with 38589 (benchmarked to 38780),
8. but I have a question for Lap Resection of right gonadal vein/Spermatic cord stump,
9. Should these be coded with two CPT codes: One to capture right gonadal vein resection and another one to capture Spermatic cord stump? VS these two are on the same location and should only be coded with one CPT code? Thank you!

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June 7, 2024

Mark and Scott discuss FAQs that came into the PRS communities.

1. Are you obligated to bill the new Category 3 CPT code for penile shockwave therapy, which we currently provide as a cash service? Specifically, do we have to use the Category 3 code when billing Medicare patients, even though there is no payment associated with it, and can we continue collecting cash without making it a Medicare billable service?
2. Is cystoscopy a moderate risk (level 4) procedure for medical decision making purposes absent other risk factors? Does it matter for MDM risk what discussion or thought process is documented? Or would that only be toward the medical necessity of the procedure?
3. CPT code 55250 says it is including postoperative semen examinations. So far we have done these in house but my physicians would like to no longer perform those and are currently looking into purchasing FELLOW kits to sell to the patients. We do not have any labs in town that perform post vas semen analysis. Any advice on what to do when patients refuse to purchase the kit?
4. If Trimix is a compounded drug wouldn't J7999 - Compounded drug, not otherwise classified be more appropriate to vs J3490?

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May 31, 2024

Mark and Scott welcome Marianne Desciose to discuss what are the biggest issues right now in RCM.

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Event Details

Location:
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New Orleans: January 31-February 1, 2025, at Harrah's

Time: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pm

Includes: Breakfast and Lunch on both days, plus 14 AAPC CEUs

The Thriving Urology Practice Facebook group.

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