Set-up Your Urology Practice for Success
Empower your Urology practice with our specialized billing expertise, tailored to enhance revenue and operational efficiency
Urology billing and coding services involve billing and coding for all diagnoses & treatments provided to correct the urinary system’s dysfunctions and the male reproductive system. Billing for urology services can be more convoluted than other specialties due to the nature of its codes & terminologies.
Urology billing and coding requires specialized expertise and knowledge, and only a urology billing specialist can handle its nuances. Urology tends to overlap with other specialties such as oncology, gastroenterology, andrology, pediatrics, endocrinology, and gynecology, making it distinctive & challenging to understand.
As Urologists focus on delivering excellent medical care, often, they lose track of their revenue cycle. Non-payment or underpayment for urology services rendered can substantially impact the practice as urology procedures are typically costly. An in-house billing team can be helpful but may cause many denials on account of the lack of expertise. Outsourcing to a focused urology billing service provider like Medical Billing Wholesalers, who is familiar with urology codes and terminologies, can offer better control over collections & denials to healthcare organizations.
CPT & ICD codes for Urology Surgeries
CPT codes are categorized based on the organs like Kidneys, Ureter, Bladder, Urethra, Male, and Female genital organs.
Code Range: 50010 – 58294
Types of Surgeries in Urology
- Incision/Biopsy
- Excision
- Transplantation
- Catheter introduction
- Laparoscopy
- Endoscopy (Cystoscopy, Urethroscopy, Cystourethroscopy, etc.,
- Repairs
ICD-10 codes
ICD-10 codes should be used based on the LCD guidelines to avoid insurance denials. ICD- 10 codes being used by our coders while coding for urology surgeries are as 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
Our Expertise in Urology Billing Services
Our team of urology billers & coders understands the nuances of urology billing and coding. We have developed a set of urology-specific best practices, which help us reduce denials and improve collections. Our client base extends across all 50 states and includes different healthcare entities, including hospitals, physician practices, and medical billing companies. Our coders are proficient in ICD-9/10, CPT, HCPCS coding based on CMS and AMA guidelines and are CUC certified (Certified Urology Coder) by the American Academy of Professional Coders (AAPC).
Applying best practices for Urology Billing & Coding
Trained urology coders are challenging to find, expensive to recruit, and their ongoing training can be quite costly. Our team comprises well-trained, CPC certified urology coders that can process 25-30 surgery reports/day. In our Urology specialty coding service, we cover the most complicated portion of the CPT codes and train our coders to handle all procedural, modifier, and diagnostic coding challenges. We ensure HIPAA compliance at all stages of the billing & coding process. Our team performs prior authorization of the eligibility & benefits of the patient to avoid denials.
Best Practices in Urology Billing & Coding
- Prior Authorization: As Urology procedures are costly, the provider must obtain prior authorization from the insurance company before rendering the services. Prior Authorizations help the organization understand the submission guidelines better, submit the claims on time, and get reimbursements instead of denials.
- Medical Necessity: The urology service provider should be able to justify the medical necessity of the course of treatment to be able to charge accordingly for the highly costly services they provide.
- Eligibility & Benefits denials: Verifying a patient's eligibility & benefits for a particular service at least 48 hrs prior can help reduce the denials.
- Missing/Invalid CLIA number (Clinical Laboratory Improvement Amendments): CLIA number should be updated while billing for the lab test.
- Non covered - Medicare will not pay for A Codes like A4357, A4334, A5114, A4340, A4331, etc., and deny as Non-Covered Services. But some secondary insurance will pay for the Medicare non-covered services.
- Coding for Maximum benefits: CPT codes should be coded with the correct units as allowed by the specific payers for specific CPTs. For example, Payers will deny CPT codes 51700, 52300, 52310, 55876, and 77263 if we bill for more than one unit.
- Medical Record Documentation in Billing CPT's 51701-51703: Codes Providers should not report 51701-51703 in addition to any other procedure that includes catheter insertion as a component.
- Modifier 59: Providers must use modifier 59 when billing for two urology services together.
- LCD Guidelines: Providers should follow LCD guidelines before billing Urology services.
Urology Medical Billing involves the systematic process of coding, submitting, and managing claims related to urological services provided by healthcare professionals. The aim is to ensure accurate reimbursement, reduce billing errors, and streamline financial processes for urology practices.
CPT (Current Procedural Terminology) codes for urology cover a range of procedures and services specific to urological care. Here are some common examples:
– Surgical Procedures on the Kidney (50010-50593)
– Surgical Procedures on the Ureter (50600-50980)
– Surgical Procedures on the Bladder (51020-52700)
– Surgical Procedures on the Urethra (53000-53899)
For a more detailed and specific breakdown of codes for various urological services, you may refer to the latest edition of the CPT codebook or consult with the experts at Medical Billing Wholesalers.
Medical Billing Wholesalers specializes in offering comprehensive Urology Billing Services. Our expertise lies in accurate coding, efficient claim submission, and ensuring timely reimbursement for urology practices. We pride ourselves on delivering tailored solutions that optimize revenue cycles for our clients.
By choosing Medical Billing Wholesalers, your urology practice can offload the complexities of billing processes. We focus on minimizing errors, streamlining revenue cycles, and providing a dedicated team to handle billing tasks. This allows healthcare professionals to concentrate on delivering quality patient care.
Our Urology Billing Services encompass a wide range of urological procedures, consultations, diagnostic tests, surgeries, and post-operative care. From billing for prostate examinations to urinary tract imaging, our services are designed to meet the unique billing needs of urology practices.
Medical Billing Wholesalers prioritizes compliance by staying abreast of the latest healthcare regulations, coding guidelines, and industry standards. Our billing team undergoes regular training to ensure precise coding and adherence to compliance requirements, reducing the likelihood of claim denials and audits.
Absolutely. Our Urology Billing Services include a robust denial management process. In the event of denied claims or billing issues, our dedicated team promptly identifies and addresses the issues, ensuring accurate claim resubmission and maximum reimbursement for your urology practice.
To get started, simply reach out to our team for a consultation. We’ll discuss the specific needs and challenges of your urology practice and customize a billing solution tailored to your requirements. Our goal is to facilitate a seamless transition and ensure the efficient management of your urology billing processes.
Ready to take your business to the next level?
Get in touch today and receive a complimentary consultation.
Ready to take your business to the next level?
Get in touch today and receive a complimentary consultation.
Benefits of Our Medical Billing and Coding Services for Urology Practices
Specialized Urology Billing Expertise
Utilizing deep expertise in Urology billing and coding to optimize your revenue cycle and reduce denials.
Certified and Trained Professionals
CPC certified team, skilled in the most common Medical Coding Software, ensuring precision in billing.
Comprehensive Insurance and Government Payer Proficiency
Expert in processing claims with major insurers, including Medicare, and knowledgeable in state-specific Medicaid policies.
Improve Efficiency and Achieve Cost Savings
Focused on reducing costs and improving efficiency, offering 50-60% cost savings through global delivery models.
Strong Prior Authorization Team
Expert team ensuring accurate patient information for streamlined and effective authorization processes.
Compliance and Risk Management
Maintain compliance with healthcare regulations and minimize legal risks.
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Take the first step towards financial excellence in your Urology practice with our expert billing services. Contact us now to unlock significant cost savings and enhanced operational efficiency!
