Practice Management

“A lot of medicine that you do in person is very provider-centric in the sense that you tend to just walk from room to room and see patients, whereas with virtual care, you need to change the workflow a little bit,” says Chad Ellimoottil, MD, MS.

Determine whether your prescribing habits are in line with your peers.

The recently released AUA 2020 Annual Census Report also contained notable data regarding telemedicine utilization.

"Either way the service is reported, the payer should require documentation be submitted for review prior to payment, and the use of the –52 on the 38571 will provide more appropriate guidance for reimbursement processing," write Jonathan Rubenstein, MD, and Mark Painter.

"Determining the PVR as part of a urodynamics test is part of the test itself and included in the payment already," write Jonathan Rubenstein, MD, and Mark Painter.

Include clear reason/diagnosis for each test, image, and diagnostic service ordered.

Urology Times reached out to 3 urologists and asked them, "How did you cope with the increased stress the pandemic has placed on your life?"

“We found that there is going to be a significant proportion of growth in the urology work force related to the number of women in urology, which is really exciting,” says Kate H. Kraft, MD.

Ellimoottil also discusses the status of his own practice with regards to in-person vs telemedicine visits.

Physician involvement in responses to payer audits is crucial.

"There are a number of physicians who would not feel comfortable using the word 'complete' unless they were confident that all prostate tissue had been removed," write Jonathan Rubenstein, MD, and Mark Painter.

"My main complaint about virtual lectures is the loss of camaraderie of seeing colleagues face to face and having casual conversations," says one urologist.

Finasteride, oxybutynin chloride, and mirabegron also rank high in latest data from CMS.

Sticking to your investment strategy can help avoid emotion-driven decisions.

Leuprolide acetate remains the most commonly used androgen suppression drug.

"Placing a catheter to irrigate obstructing blood clots (CPT 51700) is specifically included in the payment for the TURP if this complication is managed outside of an operating room," write Jonathan Rubenstein, MD, and Mark Painter.

Medical necessity must be documented on the chart in order to bill code.

“I remember being, I guess, relieved that I matched. It’s so competitive. It’s never a sure thing. You match somewhere; I remember relief with that," says 1 urologist.

CME reimbursement amount and 401(k)/401(b) are among elements to consider.

Providers must carefully outline their clinical thought process.

"Unfortunately, we have found that most if not all insurers do not pay for this code and additionally often have policies against charging patients for extra supplies, and balance billing would be a violation of their contract," write Jonathan Rubenstein, MD, and Mark Painter.

“If one performs a bladder catheterization to obtain the post-void residual, use CPT code 51701,” write Jonathan Rubenstein, MD, and Mark Painter.

Recent legislation appears to have delayed implementation of the new code.

CMS also expands the number of services payable under telehealth.

Evaluation/management changes should benefit providers and patients.

“It’s going to be a slow process for hospitals to give the proper information to their physicians so that when we’re moving on to the new coding system, we’re not doing extra work," says one urologist.

Use CPT code 52310 when a dangle is within the urethra and a grasper is used.

CPT code 99072 was created in response to extra medical practice expenses associated with patient care during the pandemic.

"We’re taking it in stride. We don’t overbook to the point where we’re overwhelmed, and we’re not exhausting ourselves," says one urologist.