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UCR 050: Physician supervision, incident to, and IDTF; FAQs - 99221-99223 denials and takebacks;  Biofeedback billing after prostate surgery; 2 surgeon surgery: colovesical fistula and robotic lap sigmoid colectomy coding.

May 11, 2021

Ray, Mark and Scott discuss physician supervision, incident to, and IDTF (Independent Diagnostic Testing Facility), also answer questions from the PRS Community and the Urology Coding and Reimbursement Group

FAQs

1. [14 minutes and 01 Seconds] Our Urology group bills inpatient hospital codes when we get called in for initial visit (99221-99223).  We have always been paid without issues and I have read Medicare guidelines stating this can be billed by each specialty.  In the past few months Aetna started denying these codes stating only one doctor, regardless of specialty is allowed to bill and we were told to bill subsequent day codes.  Now, Anthem is requesting takebacks on payments of these codes dating back to 2019.  I'm looking to see if anyone else is having this issue and is this correct for the payer?
   Thank you.
   Carrie
2. [19 minutes and 50 Seconds] Is biofeedback billable service after prostate surgery during the global days?  
3. [26 minutes and 02 Seconds] I need your assistance in coding a 2 surgeon surgery.
   Summary...I shortened immensely
   My urologist performed cysto open ended stent placement in ureter. The surgery was passed to the general surgeon for robotic lap sigmoid colectomy. The general surgeon dissected the colon from the bladder.My urologist now took over and robotically closed the colovesical fistula. The surgery was passed back to the general surgeon to finish his part.
   Would I use CPT 51999? and equate it to ? CPT code. 
   The 52005 would be included correct?
   These combined 2 surgeon surgeries where my urologist performs the
   colovesical fistula closure always confuses me.
   I appreciate your help.
   Thank you,
   Linda

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