Recent content by toria11

  1. T

    Wiki 96372

    What about when the physician administers the injection at an ASC? We have been getting denials for invalid POS for 96372.
  2. T

    Wiki Calculus Removal Same side

    Yes, 52356 for the lithotripsy and stent placement in the kidney, 52352-XS for the basket removal of the stones in the ureter.
  3. T

    Wiki 52005?

    Gotcha, thanks for the clarification on the 52005!! I do disagree with 50590-LT only, because it does take additional time/effort to reposition the machine and treat a stone in another organ. And it can be billed with a 22 or possibly even 2 units with an XS if the payer accepts...
  4. T

    Wiki 52005?

    Even so, 52005 is not documented here, correct? Just making sure I'm not missing something. All I saw was 52000. This patient also has a commercial plan, so it's possible that they will pay for the 50590 for both the kidney and the ureter. My other suggestion was to use modifier 22 for the extra...
  5. T

    Wiki Help with OP Note

    Thank you so much for looking at this so thoroughly! I appreciate your help.
  6. T

    Wiki 52005?

    The physician wants to bill 52005 here but I don't see enough evidence in the documentation that the ureter was catheterized. Wires cannot be billed for, correct? And 76000 is bundled with 50590. Thoughts? The patient was brought into the OR and placed in dorsal lithotomy position on the...
  7. T

    Wiki Billing for RN services with no supervising provider in the office

    With the new allowance of virtual supervision for incident-to (provider is available via audio/visual communication), could a nurse provider certain services (cath changes, injections, etc) and then bill under the provider that's providing the supervision?
  8. T

    Wiki Help with OP Note

    Hi all, any help with this OP note is appreciated. One of my coders used: 50590, 52318, and 52315-XU. 52315 was denied, of course. I'm thinking 52356 would have been more appropriate here since the stent was initially placed during this encounter and you can't bill for removing a stent you've...
  9. T

    Wiki Guideline on 52352 for Stone Fragment Removal after Laser?

    I have a couple providers that are adamant they should be allowed to bill 52352 when removing fragments of a stone they just lasered. I have explained that removing the fragments of a stone you've just lasered is inherent to the lithotripsy code (52356 or 52353) but I need more solid evidence...
  10. T

    Wiki Bladder irrigation 51700

    I would never advise them to document something they did not perform. I was asking for clarification of the difference between the two procedures, but no worries if you do not know. I just wonder if my providers say they irrigated the catheter free of clots when in reality they irrigated the...
  11. T

    Wiki Bladder irrigation 51700

    So for a patient with gross hematuria and clots, what documentation would you expect? Our providers often just say that they irrigated the catheter free of clots.. but they should be documenting that they irrigated the bladder free of clots?
  12. T

    Wiki High level urology problems?

    Thank you for your torsion examples! I'm trying to talk about some examples of high level problems. I'm aware that there's more to determine the overall MDM. Problems addressed is the element that I find is the least often at a high level, so I wanted some opinions on what other coders consider...
  13. T

    Wiki Bladder irrigation 51700

    51700 is not appropriate when irrigating a catheter, correct? I've seen mixed opinions on this, but I recently found this statement from the NCCI manual from 2022 "Irrigation of a urinary catheter is included in the global surgical package. CPT code 51700 shall not be misused to report...
  14. T

    Wiki Personal History of Cancer-- Invalid principal diagnosis?

    Awesome, thank you!!
  15. T

    Wiki Personal History of Cancer-- Invalid principal diagnosis?

    Thank you so much!
See more
Top