Listen On:           Apple Podcasts   •    Spotify   •   Google Podcasts   •   Stitcher


 

Thank You to Our Podcast Partner (click image to learn more)


UCR 184: FAQs - Clarification of split shared visit, and cystoscopy, dilation, and clot evacuation coding


February 23, 2024

Mark, Scott, and Ray discuss questions that came into the PRS Network: 

  1. Regarding the most recent podcast episode on shard/split visits: Medicare's policy states that only one practitioner must have face-to-face time with the patient. In our practice the physician documents an addendum on the APP's note with the medical decision making portion of the visit. Per the episode, the physician must demonstrate involvement during the visit (not afterwards) in order to bill under the physician's NPI. Is there a guideline that states the physician must document their portion in real-time as the visit with the APP takes place? If they document the MDM portion of the visit in its entirety, isn't that enough to bill for the "substantive portion of MDM" as required by Medicare?
  2. For 52001, we commonly use this code for cysto and clot evacuation for gross hematuria under general anesthesia requiring rigid scope. Are physicians allowed to use this code for cystoscopy and irrigation of a clot with a syringe under local procedure or should they use 52000 + 57000?
  3. For 52281, does passage of the cystoscopy to dilate a narrowing in the urethra or meatus count? Or it is only meant to be used for cases where the meatus is cut or dilators or DVIU are used?

 

Join the Documentation for Reimbursement Challenge - Starts 2/26/24

Click Here for Information and to Join


PRS Billing and Other Services

Click Here to Get More Information and Request a Quote


   The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/ 


   Join the discussion:

Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.



Click Here to Start Your Free Trial of AUACodingToday.com