Pearls and pitfalls: Those may not be words you’re used to applying to urology billing and coding, but practical dos and don’ts—like those presented in the latest urology coding webinar by educator Michael Ferragamo—can help you stay on top of CPT® and ICD-10 code changes in the year ahead. In his session, Ferragamo delivers clear explanations, guidance, and examples of what’s changed—and how to cope.
Remember that every little rule change affects your practice’s bottom line. And learning to avoid common coding mistakes goes a long way to curbing denied claims and optimizing revenue. Here’s a quick preview of the 2019 coding updates to get you started…
3 New Urology CPT® Codes: UTD & TUMT
Starting with urology CPT® codes, there are three new codes to add to your toolbox for 2019:
- 50436, Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed
- 50437, Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed; including new access into the renal collecting system
- 53834, Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy
For deletions, there’s not much to cover: Just remove 50395, Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract, percutaneous.
Code revisions for 2019 are minor as well, Ferragamo explains: Just learn the few small tweaks to 74485 and you’re good to go.
New ICD-10 Codes: Urethral Stricture & Diagnostic Testing
Urology is one of the specialties seeing vast changes to ICD-10 codes for 2019. For instance, Chapter 14 (Diseases of the Genitourinary System) includes 17 new codes for urethral strictures.
Plus: With CMS not deleting the urethral codes already in use, you now have more than 20 to choose from. Do be sure to read each definition carefully to select the right one.
Other edits to urology ICD-10 codes include changes to Chapter 18 (Symptoms, Signs, and Abnormal Clinical and Laboratory) regarding abnormal findings in urine as well as abnormal testicular diagnostic testing.
Quick Tip: Although all the changes won’t affect your practice daily, make a note of your “favorites”—the ones you use the most—and add them to your cheat sheets for quicker and more accurate coding.
Reminder: As explained in a previous post, 2019 ICD-10 are already in play: They took effect October 1, 2018.
Avoid 2 Common ICD-10 Pitfalls
These two mistakes, as described by urology coding consultants in Urology Times, are quite common, so don’t feel alone if you’ve seen them in your practice. Just learn how to avoid these and similar errors:
- (Mis)use of symptom codes: Be careful using these codes if the symptom is no longer present. They can typically still be used if there’s no diagnosis, but not if a diagnosis has been established.
- 9, malignant neoplasm of bladder site unspecified. As with all “unspecified” codes, use extra caution here. Most practice notes will specify the part of the bladder from which a tumor was removed. But if the documentation you’re working with doesn’t, check with the physician first before using this code.
Plus: Medicare Physician Fee Final Rule
Along with all the 2019 CPT® and ICD-10 code updates, you’ll also need to get up to speed on the Medicare Physician Fee Final Rule, issued on November 23. Pay special attention to changes to new values for urology codes so you’re not caught surprised by adjustments to payment for services rendered.
As you can see, 2019 is going to be a year of important changes in the coding world, meaning that medical coding certification and training is more important than ever. Regular professional development training can keep you on the cutting edge. Ferragamo’s webinar, “Coding Pearls and Pitfalls in Urology: What You Need to Know This Year,” is filled with clear instruction and answers to challenging questions to give you an extra boost in confidence in your coding & billing practices.
