Multiple coding changes have been made either half-yearly or yearly basis with small reporting to the medical community from Centers for Medicare & Medicaid Services (CMS) as well as other private carriers. Owing to multiple modifications and their extended reporting, billers, and coders, and physicians are unaware of new guidelines until months later when it has already a loss of revenue faced by providers mainly due to unanticipated wrong coding. Multiple ICD-10 and CPT codes modification came into the picture for urology in 2020. Providers require to understand the updates and related urology medical billing guidelines to make sure correct reporting and timely payment. This article is aim on different coding updates for urology in the year 2020 that one should understand to lower which claim denials, as well as reduced and delayed reimbursement.
Fresh ICD-10 Codes
Diagnosis codes have to be allocated to the greatest known level of precision. Effective from 1st October 2019, ICD-10 code modification for primary urologic problems contain codes additions, code description changes, and a new instructional note without description change
Changes in CPT Codes
New Category III Code for Transurethral ablation of malignant prostate tissue by high-energy water vapor thermotherapy, including intraoperative imaging and needle guidance
Category I and Category III known as T codes are part of CPT codes. Category I codes are termed as standard codes utilized to report services, on the other hand, Category III codes are utilized to trace the usage of upcoming procedures, technologies, and services.
In 2020, a new series of category III codes 0587T-0590T for insertion, replacement, or removal in incorporated single device neurostimulation system and the analysis and testing came into the picture on Jan 1, 2020. The new codes have been added to account for the changes required to operate these services
- 0582T – Transurethral ablation of malignant prostate tissue by high-energy water vapor thermotherapy, including intraoperative imaging and needle guidance
- 0548T – Transperineal periurethral balloon continence device; bilateral placement, including cystoscopy
- 0549T – Transperineal periurethral balloon continence device; unilateral placement, including cystoscopy
- 0550T– Transperineal periurethral balloon continence device; removal, each balloon
- 0551T – Transperineal periurethral balloon continence device; adjustment of the balloon(s), fluid volume
- 05871– Percutaneous implantation or replacement of integrated single device neurostimulation system including electrode array and receiver or pulse generator, including analysis, programming and eimaging guidance when performed, posterior tibial nerve
- 0587T – Percutaneous implantation or replacement of an integrated single device neurostimulation system including electrode array and receiver or pulse generator, including analysis, programming and imaging guidance when performed, posterior tibial nerve
- 0589T – Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician or other qualified health care professional, posterior tibial nerve, 1-3 parameters
- 0590T – Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician or other qualified health care professional, posterior tibial nerve, 4 or more parameters
Eliminated and new biofeedback codes
New – Two new time-based codes have been designed in such a way to permit physicians to “most precisely explain and be compensated for the amount of time and effort spent face to face with an independent patient”. The two new time-based biofeedback codes are:
90912 Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient.
90913 . . . each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient (List separately in addition to code for primary procedure)
Eliminated code
The deleted codes are as follow:
90911 Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry
Revisions
The 2020 CPT code modifications for urology contains revisions under the urinary system/bladder introduction:
The parenthetical note following code 51715 (Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck) has been deleted
The descriptor of Orchiopexy
CPT 54640 – Orchiopexy, inguinal approach, with or without hernia repair has been revised to
CPT 54640 – Orchiopexy, inguinal or scrotal approach
Urology practitioners require to upgrade templates in order to load the new codes. We are here to share your billing and coding responsibilities. In addition to this, we have a dedicated team of billers and coders with knowledge of upgraded CPT and ICD-10 urology codes. Collaborating with correct billing and coding service provider will help you to enhance your revenue performance. Feel free to contact us, until we explore our billing and coding capabilities, which could highly beneficial for you to get timely reimbursed.
