January 2, 2026 In this episode, Scott, Mark, and Dr. John Lin dive into the complexities of billing G2211, the Medicare add-on code for complex E/M visits, which now pays nearly $18 per use. They unpack a real-world case where a hospital system’s blanket use of modifier 25 is preventing employed physicians from getting reimbursed for G2211, potentially costing them thousands in RVUs. The discussion covers payer-specific rules, how to appeal inappropriate denials, how contract structu...
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January 2, 2026 In this episode, Scott, Mark, and Dr. John Lin dive into the complexities of billing G2211, the Medicare add-on code for complex E/M visits, which now pays nearly $18 per use. They unpack a real-world case where a hospital system’s blanket use of modifier 25 is preventing employed physicians from getting reimbursed for G2211, potentially costing them thousands in RVUs. The discussion covers payer-specific rules, how to appeal inappropriate denials, how contract structu...
UCR 252: Documentation and Coding for - Aborted Stone Procedure, Urethral Pressure Studies, Prostate Biopsy Guidance, and Fiducial Marker Placement
Urology Coding and Reimbursement Podcast
29 minutes
5 months ago
UCR 252: Documentation and Coding for - Aborted Stone Procedure, Urethral Pressure Studies, Prostate Biopsy Guidance, and Fiducial Marker Placement
July 25, 2025 In this episode, Scott, Mark, and Ray answer coding questions submitted through the PRS Help Desk. 1) Payor: Medicare State: FL Code/Codes: 52353-52 and 52332-59-51 Catagory: Kidney Stones Question: If I have to abort a planned ureteroscopy and laser lithotripsy because the UO is too narrow to pass the ureteroscope so I place a stent. Can I bill the 52353-52 and 52332-59-51 2) Can you clarify what documentation is required to be able to code 51729? Is the length of...
Urology Coding and Reimbursement Podcast
January 2, 2026 In this episode, Scott, Mark, and Dr. John Lin dive into the complexities of billing G2211, the Medicare add-on code for complex E/M visits, which now pays nearly $18 per use. They unpack a real-world case where a hospital system’s blanket use of modifier 25 is preventing employed physicians from getting reimbursed for G2211, potentially costing them thousands in RVUs. The discussion covers payer-specific rules, how to appeal inappropriate denials, how contract structu...
