Structure of Urology Medical Billing you should understand

Urology medical billing is the process by which healthcare practitioners bill insurance companies for services provided to patients. In order to complete this formality, medical billing and coding experts assign designated codes to various procedures to restructure the process of billing certain procedures.

Medical billing companies assist in healthcare facilities to optimize the revenue management cycle, fast pace the payment circle, and ensure that a facility never runs into the negative bottom line at the end of each month.

Under the latest ICD-10 system, new categorizes of procedures have been designated into a seven-digit code made up of alphanumeric characters. Thus while undertaking urology billing, a procedure can be specifically categorized according to its type, with what part of the body is being affected, and what equipment is used when conducting the procedure, plus the body part being affected, and any other notifications that help to pinpoint its exact purpose, all this without actually listing the patient’s diagnosis in the code.

Urology Medical Billing Procedures – What has changed?

Urology billing and coding are very much similar to other medical services. Stating under the Medical and Surgery category, the billing codes for urinary-related procedures starts with ‘0T’ – and will continue based upon the type of procedure is being performed.

For example, if the procedure is to insert an artificial sphincter, equipment used to help with incontinence, into the patient’s urethra, the perfect billing code would be 0THD0LZ.

The ‘0T’ here denotes it is a surgical procedure of the urinary system. The ‘H’ implies that the root operation is Urology medical billing an insertion. The ‘D’ symbolizes the part of the body in which the final operation is to happen; in this case, it is the urethra. The ‘0’ specifies that the approach to the procedure is an open one.

An open approach is performed when the patient is cut open to performing certain procedures. The ‘L’ suggests that the equipment being injected is an artificial sphincter, while the ‘Z’ signals that there are no additional qualifiers by which to define the procedure.

Understanding Structure of Urology Medical Billing and Codes

Keep in mind that Urology billing codes differ based upon the procedure the patient is having.

For instance, if the patient is to be treated for his right kidney repair, the code would be 0TQ00ZZ.

Here again ‘0T’ places the code into the category of surgical procedure of the urinary system. The ‘Q’ entitles the root operation as a repair.

The ‘0’ denotes that it is the right kidney which is under treatment or being repaired. The next ‘0’ means that it is an open-end procedure. The ‘Z’ is there to show that the approach to healing is an open approach, and it denotes that there are no other qualifiers for this procedure.

After entering the procedure codes the entire thing is then transferred onto a billing form which is then sent to the insurance company. The insurance payer then converts the code to figure out how much of the procedure is covered by a designated insurance plan the particular patient has.

From here, the insurance payer will reimburse its designated amount to the urology practitioner or facility, which will then bill (any) remaining balance to the patient. Patients hardly, if ever, see the specific billing code that is assigned to them for any procedures they may have. So, all in all, this is meant for internal use and documentation.

Urology billing and coding for the procedure can be problematic for those who do not know the specific codes for precise procedures. Once you know the pattern and the codes, it is stress-free to identify the procedure being performed, which further allows the billing to become a streamlined exercise. In the end, remember that to get fully reimbursed the key to success lies in the accuracy of your codes and documentation.

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