Urology billing and coding services include billing and coding for all diagnoses and treatments offered to repair urinary system and male reproductive system dysfunctions. Because of its codes and terminology, billing for urology services might be more complicated than for other specialties.
Urology billing and coding need particular experience and understanding, which can only be handled by a urology billing professional. Urology is different and challenging to grasp since it overlaps with other specialties such as oncology, gastroenterology, andrology, pediatrics, endocrinology, and gynecology.
In 2020, significant ICD-10 and CPT code modifications for urology went into effect. Practitioners must grasp the revisions and accompanying urological medical billing requirements to guarantee proper reporting and timely reimbursement.
CPT Codes For Urology
CPT codes are divided into Category I codes and Category III codes. While Category I codes are used to record regular services, Category III codes are used to track the use of advancing technology, services, and techniques.
Category I Codes:
CPT Code 53451: Bilateral implantation of a periureteral transperineally adjustable balloon continence device, incorporating cystourethroscopy and imaging guidance.
CPT Code 53452: CPT code 53452 specifies revision of past hypospadias repair of extreme complexity that necessitates more labour than a flap, patch, or graft and includes removal of previously built structures.
CPT Code 53453: The removal of the continence device’s balloon is described in code 53453. For each balloon removed, the code is provided.
CPT Code 53454: The physician adjusts the fluid volume of one or more balloons used as a continence device adjacent to the urethra using a percutaneous method.
Old Category III Codes:
The AMA designates Category III codes as transitory codes. Even though the codes are only temporary, they are essential to the system. The following are the AMA criteria for Category III codes: “Category III codes permit data collection for new technologies, services, procedures, and service paradigms. The use of unlisted codes does not allow for precise data collection. If a Category III code is available, it must be reported instead of an unlisted Category I code.
CPT Code 0672T: It includes endovaginally cryogen-cooled, monopolar radiofrequency remodeling of the tissue around the female bladder neck and proximal urethra for urine incontinence is characterized as endovaginally cryogen-cooled, monopolar radiofrequency remodeling for urinary incontinence.
CPT Code 0655T: This CPT code is for transperineally focused laser ablation of cancerous prostate tissue. Imaging recommendations are included and should not be reported separately.
New Category III Codes
CPT codes are divided into Category I codes and Category III (T codes). While Cat I codes are used to recording regular services, Cat III codes”) are used to track the use of developing technologies, services, and processes.
On January 1, 2020, a new set of category III codes 0587T-0590T for the installation, modification, or removal of an integrated and comprehensive device neurostimulation system and the analysis and testing went into effect. The following additional codes have been introduced to account for the variations necessary to fulfil these services:
0582T — Transurethral ablation of cancerous prostate tissue using high-energy water vapor thermotherapy.
0548T — Transperineal periureteral balloon continence device; bilateral implantation, including cystoscopy.
0549T — Transperineal periureteral balloon continence device; unilateral placement, including cystoscopy.
0550T — Transperineal periureteral balloon continence device; removal of each balloon.
0551T — Transperineal periureteral balloon continence device; balloon(s), fluid volume adjustment.
05871 — Percutaneous insertion or maintenance of an integrated single device neurostimulation system, including an electrode array, and analysis, programming, and imaging guidance when done, posterior tibial nerve.
0588T — Revision or removal of integrated single device neurostimulation system including electrode array and analysis, programming, and imaging guidance when done posterior tibial nerve
0589T — Electronic analysis with simple programming of implanted integrated neurostimulation system including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician posterior tibial nerve.
0590T — Electronic analysis with complex programming of implanted integrated neurostimulation system including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician posterior tibial nerve.
Important Points To Consider
- According to a recent Urology Times article, because Category III codes are a distinct subset of the CPT code set, urologists and practices must understand their worth, when to utilize them, and when they can be reimbursed.
- These services are not individually recorded since the code descriptors incorporate imaging, coding, and analysis into the insertion operation.
- There are two codes for reporting electronic analysis: essential (0589T) and complicated (0590T). These codes should be utilized when programming services are conducted independently of insertion and revision/removal services.
Urology clinics must change their templates to integrate the updated codes for billing Category III codes. They must first examine payer guidelines to determine how to proceed. Urology medical billing businesses keep up with ICD-10 and CPT code changes. The most accessible approach to submitting the correct codes for services delivered is to work with a reputable service provider.
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