Rubenstein is compliance officer and medical director of coding and reimbursement, United Urology Group and Chesapeake Urology, in Towson, Maryland.
Coding Q&A: Billing for female total urethrectomy with complete cystectomy
January 5th 2024"When we think about a typical procedure for performing a radical cystectomy for cancer with an ileal conduit, that would typically involve lymph node dissection, and therefore CPT 51595 would be best chosen to report that combined procedure," write Jonathan Rubenstein, MD, and Mark Painter.
Billing for nephroscopy with ureteroscopy and laser lithotripsy
July 19th 2023"CPT codes 50080 and 50081 describe the antegrade approach to stone removal requiring lithotripsy through a nephrostomy tract, with 50080 being reported for stones less than 2 cm in size in a single location, whereas 50081 would be reported for large or complex stones, stones in multiple locations, or stones in the ureter (such as in the example provided)," write Jonathan Rubenstein, MD, and Mark Painter.
How to bill Principal Care Management codes when 2 specialists are involved
December 21st 2022"PCM codes require the practitioner to develop a disease-specific care plan, to obtain a patient’s verbal or written consent, and to educate the patient on PCM," write Jonathan Rubenstein, MD, and Mark Painter.
How to get reimbursed for multiplex PCR urine cultures
November 8th 2022"Although Medicare has developed previous coverage directives for several types of PCR tests outside of UTI detection and there are sound arguments for the use of PCR tests in detecting UTIs, Medicare only recently published a local coverage determination that included the use of PCR tests for UTI detection," write Jonathan Rubenstein, MD, and Mark Painter.
Why can’t CPT 50436 and 50437 be used when performing percutaneous nephrolithotomy?
October 14th 2022"For several reasons, the percutaneous nephrolithotomy codes needed to be revised, as the language of the descriptor and what was included and not included was confusing and ambiguous," write Jonathan Rubenstein, MD, and Mark Painter.
Laparoscopic simple prostatectomy code is coming
October 10th 2022On January 1, the following CPT code will be active: 55867 (laparoscopy, surgical prostatectomy, simple subtotal [including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy], includes robotic assistance, when performed).
Urology Coding: Can CPT 51728 and 51741 be billed together?
July 12th 2022"There are a number of urodynamic tests that can be performed. Urodynamic studies are not a one-size-fits-all procedure, but rather the tests performed should be chosen based upon the patient presentation and the question that needs to be answered by the urodynamic studies," write Jonathan Rubenstein, MD, and Mark Painter.
What is the best way to report an encounter when both the kidney and bladder are imaged?
June 10th 2022"For appropriate billing and coding, there are 2 important issues to be satisfied: medical necessity and documentation supporting the performance of the procedure," write Jonathan Rubenstein, MD, and Mark Painter.