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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?

Scott Serels, MD, Director, Bladder Control Center of Norwalk, Connecticut This Urology Times supplement was produced by Advanstar Communications, Inc, under an unrestricted educational grant from Ortho-McNeil Pharmaceutical, Inc.The views and opinions expressed in this supplement do not necessarily reflect the views of Advanstar Communications, Inc or Ortho-McNeil Pharmaceutical, Inc.Sponsored and supported by a grant from Ortho-McNeil Pharmaceutical, Inc.Cover image ?Bryson BioMedical/Custom Medical Stock Photo.Copyright ?2004 Advanstar Communications, Inc. All rights reserved.

Quebec City, Quebec--The good news is that most patients being treated for erectile dysfunction report that their treatment is working. The bad news is that a significant percentage of these same patients are often lost to follow-up for that very reason, according to a study by urologists from McGill University.

Minneapolis-American Medical Systems announces the launch of the AMS 700CXR Penile Prosthesis, which is designed for difficult surgical cases and re-insertion procedures.

The University of Nebraska Medical Center has received a 5-year grant totaling almost $9.9 million from the National Institutes of Health to further the understanding of cell signaling in relation to a variety of cancers, including cancer of the prostate.

Richard D. Williams, MD, has been elected president of the American Foundation for Urologic Disease by its board of directors, the foundation announced.

When it comes to deciding the type of treatment a man with prostate cancer receives, his age often takes precedence over life expectancy, according to a study from the University Health Network in Toronto.

The rate of use of high-cost operative procedures is not lower among Medicare beneficiaries enrolled in for-profit health plans than among those enrolled in not-for-profit health plans, according to a study in the New England Journal of Medicine (2004; 350:143-150).

Patients with Gleason scores =7 receiving an investigational form of immunotherapy for prostate cancer showed a significant survival advantage.

Repeating a familiar theme of his administration, President Bush said Tuesday that the United States must rid itself of frivolous medical liability suits.

The likelihood that an older patient will be hospitalized within a week or die shortly after undergoing prostate resection and other common procedures in an outpatient setting depends on health-related characteristics of the patient and where the surgery was performed, according to a recent article in Archives of Surgery (2004; 139:67-72).

The American Board of Urology has named two new trustees for 2004-2005-Paul H. Lange, MD, of the University Washington, Seattle, and Michael O. Koch, MD, of Indiana University, Indianapolis.

A Houston physicians' group has settled federal antitrust charges that stemmed from its use of the messenger model of dealing with health plans, according to a report in the AMA's American Medical News.

In a study comparing biochemical failure rates of popular treatments for localized prostate cancer, low-dose external beam radiotherapy showed the highest failure rate.

Obese men with prostate cancer are more likely to have aggressive tumors and to experience cancer recurrence after surgery compared with men of normal weight or those who are overweight but not obese, according to two new studies.

It's official. As widely anticipated, the Centers for Medicare & Medicaid Services announced that the nation's physicians would receive a 1.5% increase in payments for services under the Medicare Physician Fee Schedule in calendar year 2004.

Over the last 20 years, radical retropubic prostatectomy has evolvedto become the standard of care in men with localized prostate cancer. Becauseof the morbidity of this procedure, however, interest has grown in the developmentof non-surgical modalities. Unfortunately, many of these non-surgical approaches,such as monotherapy with radioactive seed implantation, have resulted indisappointing results or excessive morbidity, as in first-generation cryotherapy.

Be prepared for a short-term gain that may be a long-term pain. The AmericanMedical Association has claimed a major political victory with passage ofthe Medicare Prescription Drug Improvement and Modernization Act of 2003,and I certainly hope the AMA is correct. Certainly the pay increase overthe next 2 years is great. However, I have concerns about many of the otherissues addressed in the bill.

Winston-Salem, NC--Well over one-third of men with localized prostatecancer are opting for brachytherapy as their primary treatment, accordingto a recently published study. Past and current data indicate the proportionof prostate cancer patients choosing brachytherapy has grown from 1.4% in1992 to 3.0% in 1995 to 36% in 1999-the latest year for which comprehensivedata are available.

Montreal--Novel approaches to percutaneous nephrolithotomy, includinguse of a stent instead of a tube and using smaller tubes and stone "cones,"are helping to optimize this procedure. Researchers agree that improvingsafety and reducing morbidity are the goals of these new techniques.

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.

Personal digital assistants, or PDAs, have now reached critical mass, and nearly 25% of physicians use them on a daily basis.

Montreal--Using a high-powered potassium titanyl phosphate (KTP) laser to vaporize prostate tissue is proving to be safe and effective as a treatment for urinary retention in men.

Waltham, MA-Praecis Pharmaceuticals has received FDA approval to market abarelix (Plenaxis) for men with advanced prostate cancer.

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

Montreal-High-intensity focused ultrasound (HIFU) continues to show promise for the local treatment of prostate cancer. When initiated early in the disease, the minimally invasive procedure offers good efficacy results with little morbidity, according to several European studies presented at the World Congress on Endourology here.

Chicago--Advances in technology and technique are allowing computed tomography to image lesions and tumors as small as 2 mm in diameter in the kidney, bladder, and urinary tract of high-risk patients, according to a study presented here at the annual meeting of the Radiological Society of North America.

The long-awaited results of the landmark Medical Therapy of Prostatic Symptoms (MTOPS) study have been published in The New England Journal of Medicine (2003; 349:2387-98).

Health and Human Services Secretary Tommy G. Thompson has named Dennis G. Smith as interim head of the Centers for Medicare & Medicaid Services.

Scientists say they have coaxed uncommitted mouse embryonic stem cells to grow into sperm cells in the laboratory.