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Reimbursement for urologic evaluation and management services increased by one-half since 1995, while surgical reimbursement rates have decreased by about one-third, according to a study in the November Journal of Urology (2004; 172:1958-62).

The Centers for Medicare & Medicaid Services said it has made "significant" changes in Medicare's approach to paying for drugs administered in the physician's office that will allow increased coverage in 2005 for both the drugs and their administration.

You collect your money at the time of service, and you have no accounts receivable for Medicare patients.

Bladder ultrasound is noninvasive and relatively easy to perform, which may explain its increased usage in recent years. However, the American Board of Urology has expressed concern that urologists may be overusing the test. In this exclusive Urology Times interview, Pat Fulgham, MD, president of Urology Clinics of North Texas, Dallas, discusses data on the dramatic shift in bladder ultrasound usage by some urologists. Dr. Fulgham, who teaches an annual AUA course on ultrasound, also discusses clinical and reimbursement guidelines clinicians should follow. The interview was conducted by UT Editorial Consultant Robert C. Flanigan, MD, professor and chairman of the department of urology, Loyola University Medical Center, Maywood, IL.

Computer labels withstandchemicals, extreme temps

Washington--Even though the new Medicare physician fee schedule rule increases physician payments by 1.5% overall for Medicare services, urologists are facing a 13% reduction, according to AUA officials.

Q A pediatric urologist I code for is concerned that we cannot bill/code for both orchiopexy and a hernia repair done during the same operating room session. Do you have any documentation on this matter? When you look up 54640 in CPT 2004, it references, "For inguinal hernia repair performed in conjunction with inguinal orchiopexy, see 49495-49525." In the Medicare Correct Coding Guidelines, I do not see any edits stating not to bill both procedures together.

CMS estimates that Medicare payments to urologists will decrease 13% in 2005.

The procedure should be of a durationand complexity that will permit the patient to recover and be discharged.

Minnetonka, MN-The FDA has cleared for marketing American Medical Systems' 700 Tactile Pump, the latest addition to the AMS 700 line of penile prostheses.

Minnetonka, MN-The FDA has cleared for marketing American Medical Systems' 700 Tactile Pump, the latest addition to the AMS 700 line of penile prostheses.

Only by qualifying for a special modifier would a procedure be 'pulled' from the global

Settlements create monetary funds, prevent companies from engaging in harmful practices

Louis Potters, MD has been appointed to the Centers for Medicare &Medicaid Services Advisory Panel on Ambulatory Payment Classification Groups,or APC Panel.

Reduced reimbursement for chemo will cause urologists to make drasticchanges, AUA says

Fax-to-e-mail and e-mail-to-fax services can save you time and moneywhen traveling

Amounts paid into Health Savings Accounts can be used to reimburse medicalexpenses

Error rate of 5.3% is below national average compared with other majorspecialties

Q I am in a multiple-physician urology practice. One of our physiciansbelieves that billing 52332 with 52352 or 52353 with a ­59 modifiershould be paid, and that billing 52005 with 52332 with the ­59 modifiershould be paid (ie, 52005-59). When is it appropriate to use the ­59modifier?

Minneapolis--Surgeons and other physicians across the country continueto deal with the higher costs of practicing medicine in the face of decliningreimbursements. Those factors added up to lower profit margins for U.S.physician groups in 2002 and a continuing awareness of the need to pay attentionto all of the vagaries of the business of practicing medicine. For the mostpart, urologists showed little change in reimbursement.

Patients with nephrolithiasis frequently have metabolic abnormalities that promote calculus formation and, when identified and corrected, may attenuate stone activity.

Also, always use the ­59 modifier when inserting an indwelling stentduring ureteroscopy

San Jose, CA?The Centers for Medicare and Medicaid Services has approved an application for assigning a new technology Ambulatory Payment Classification for photoselective vaporization of the prostate (PVP) to treat BPH.

Instructions for coding for all Evaluation and Management (E&M) services have several elements in common. One should always base documentation and coding on the amount of work required to provide good patient care.

Physician must be immediately available, and the service must be performedby an employee

Although antibiotics are commonly used to treat symptoms of chronic pelvicpain syndrome, this approach is beneficial in a relatively small subsetof patients, and urologists must consider alternative treatment modalities,including physical therapy. In this exclusive Urology Times interview, JeannettePotts, MD, discusses current research and her own views on the diagnosisand treatment of chronic prostatitis. Dr. Potts is a member of the staffat the Cleveland Clinic Glickman Urological Institute. The interview wasconducted by Philip M. Hanno, MD, of the department of urology, Universityof Pennsylvania, Philadelphia.

FDA OKs treatment for men with testosterone deficiency. Livingston, NJ-The FDA has approved Columbia Laboratories' testosterone buccal system (Striant mucoadhesive) for testosterone replacement therapy. The transbuccal treatment is for men with conditions associated with a deficiency or absence of endogenous testosterone, including hypogonadism.

Q Can I be reimbursed for in-office injection of botulinum toxin inpatients with refractory overactive bladder? If so, how?

Wilmington, DE-The federal government will likely pursue urologistsin a second round of investigations surrounding the fraudulent marketingand sale of luteinizing hormone-releasing hormone agonists for prostatecancer. Just how far the probe will extend remains a source of debate amonglegal experts familiar with the case.

Up to 5% of Americans will be affected by stone disease over the courseof their lifetime. Despite major advances in shockwave lithotripsy and endoscopictechnologies, we must not underestimate the role of medical therapy in preventingstone recurrence. Two studies presented at the recent AUA annual meetingand reported in this issue of Urology Times (see page 10) offer valuablelessons on this aspect of stone management.