Urology Coding and Reimbursement Podcast
Episodes
310 episodes
UCR 261: Government Shutdown Impact and a Human Perspective on AI in Urology
October 3, 2025 In this episode, Scott, Mark, and Ray Painter discuss two timely and important topics. First, they break down the current government shutdown and its effects on Medicare claims processing, including th...
UCR 260: Potential Government Shutdown and Telehealth – What Urology Practices Need to Know Now
September 26, 2025 In this episode, Scott, Mark, and Ray discuss the looming federal government shutdown and how it could impact urology practices—especially telehealth services. They explain the latest developments i...
UCR 259: Bladder Cancer Reimbursement Strategies – Using Unlisted J Codes and the New Zusduri Hub Tools
UCR 259: Bladder Cancer Reimbursement Strategies – Using Unlisted J Codes and the New Zusduri Hub ToolsSeptember 19, 2025 In this episode, Scott, Mark, and Ray Painter dive into bladder cance...
UCR 258: Telehealth in Limbo — What’s Next as the Deadline Looms?
September 17, 2025 In this episode, Scott, Mark, and Ray Painter break down the latest updates on the future of Medicare telehealth coverage as the September 30, 2025, deadline approaches. Mark shares insights into re...
UCR 257: Clearing the Field — Catheters That Suck and Understanding C9761
September 5, 2025 In this episode, Scott, Mark, Ray, and special guest Dr. John Lin delve into the nuances of coding and billing for steerable vacuum-assisted catheters used in large stone removal. They clarify the di...
UCR 255: Medicare’s WISeR Program – Prior Auth Comes to Traditional Medicare and Facility Payments for Catheters That Suck
August 15, 2025 In this episode, Scott, Mark, Ray, and special guest Dr. John Lin dive deep into Medicare’s upcoming Wiser Program—set to begin in 2026—which brings prior authorization to traditional Medicare for sele...
UCR 256: A Hybrid Urology Practice—Dr. Marc Rose’s Concierge Model Journey
August 22, 2025 In this special episode, Scott, Mark, and Ray welcome Dr. Marc Rose, a practicing urologist in Vero Beach, Florida, to share his journey of transitioning to a hybrid urology practice that combines trad...
UCR 254: Downcoding on the Rise – What to Watch For, and is United Healthcare getting out of Medicare Advantage plans?
August 8, 2025 In this episode, Scott, Mark, and Ray discuss the troubling expansion of automatic E/M downcoding by payers—and what your practice can do about it. Mark explains which payers are leading this trend, how...
UCR 253: Complex Bladder Clot Evacuation Coding and How to Bill Pre-Surgical E/M Services
August 1, 2025 In this episode, Scott, Mark, and Ray answer coding questions submitted through the PRS Helpdesk. Pay er: Anthem BCBSState: NVCode/Codes: Tranurethral resection of bladder clot ...
UCR 252: Documentation and Coding for - Aborted Stone Procedure, Urethral Pressure Studies, Prostate Biopsy Guidance, and Fiducial Marker Placement
July 25, 2025 In this episode, Scott, Mark, and Ray answer coding questions submitted through the PRS Help Desk. 1) Payor: MedicareState: FLCode/Codes: 52353-52 and 52332-59-51Catagory: Kidney ...
UCR 251: Initial Reactions to the 2026 Proposed CMS Rules
July 18, 2025 In this episode, Scott, Mark, and Ray Painter break down their first impressions of the 2026 proposed Medicare physician fee schedule. From conversion factor changes and telehealth updates to significant...
UCR 250: Advocacy, Policy, and the Future of Urology with Dr. Peter Bretan
July 11, 2025 In this special episode, Dr. Peter Bretan—president of the AACU—joins Scott, Mark, and Ray to share his journey from transplant surgeon to national urology advocate. He highlights the power of grassroots...
UCR 249: New FDA Rulings – What It Means for Coding, Coverage, and Reimbursement
June 27, 2025 Scott, Mark, and Ray discuss how new FDA rulings—like the recent update for Rezūm—impact coverage, coding, and reimbursement. They walk through the layers of medical necessity, CPT codes, payer policies,...
UCR 248: Coding for BPH and Bladder Stones in One Surgery, Tips for New Urology Coders, and a Telehealth Legislative Update
June 20, 2025 In this episode, Ray, Mark, and Scott answer questions that came into the PRS Helpdesk and give an update on Telehealth and where it stands.Patient with BPH and bladder stones. When tre...
UCR 247: 2 New Denial Twists - 1) getting E/M, G2211, and UA paid; 2) downcoding; and revisiting coding for graft around the urethral anastomosis during prostatectomy (from Episode #234)
June 13, 2025 In this episode, Ray, Mark, and Scott discuss recent denial issues from Aetna and Humana and offer some possible solutions. They also revisit a question covered in Episode #234: billing for amniotic tiss...
UCR 246: ER Consult for ED, Increasing Upfront Patient Collections, Billing for PAE Conscious Sedation, and Can You Bill Extra If It Sucks?
June 6, 2025 In this episode, Ray, Mark, and Scott welcome back Dr. John Lin to discuss topics brought up on the Thriving Urology Practice Facebook Group.1) Just got a call from ER. 19 year-old ca...
UCR 245: Prostate Biopsy Code Overhaul, E/M with 51798 Modifier Recommendations, and Coding Robotic Vasectomies
May 30, 2025 In this episode, Mark and Scott address upcoming significant changes to the prostate biopsy codes and provide guidance on correctly applying modifiers 25 and 59 when billing procedure 51798 and an E/M ser...
UCR 244: Remote Uroflow Billing, High MDM Clarity, and Medicare Advantage Contract Challenges
May 23, 2025 Scott, Mark, and Ray answer listener questions on coding for remote uroflowmetry, defining high-complexity MDM, and dealing with low Medicare Advantage reimbursements. They discuss CPT code options, provi...
UCR 243: Introducing the PRS Coding and Reimbursement Hub: Featuring Jelmyto as the Example
May 16, 2025 Scott and Mark switch roles to introduce the new PRS Coding and Reimbursement Hub, featuring Jelmyto as an example. The Hub helps practices simplify workflow, coding, and reimbursement processes. Scott ex...
UCR 242: Pediatric penile torsion repair, MA scope of practice, and incident to billing for a hospital-employed urologist
May 9, 2025 In this episode, Scott, Mark, and Ray answer questions that came into the PRS Helpdesk.One of my specialties is pedsurology and there is just not much guidance for surgery coding.Is it appr...
UCR 241: Recap of AUA 2025 – Exciting New Tech, Reimbursement Challenges, and Community Connections
May 2, 2025 In this episode, Scott, Mark, and Ray share highlights from the AUA 2025 Annual Meeting in Las Vegas, discussing exciting new technologies, reimbursement challenges, key conversations, and updates from the...
UCR 240: 2025 Practice Pressures - PE Slow-Down, Staffing Gaps, Physician Shortages, & Efficiency Planning
April 25, 2025 Scott, Mark, and Ray discuss the pressures of Urology practice in 2025. They talk about what you need to be aware of and why you need to plan for the future.Free Kidney Stone Coding Calculator...
UCR 239: Incident To billing for a hospital-employed urologist at a freestanding clinic, Incident To Target Probe and Educate (TPE) Audit, and correct coding for ASC stent removal without cystoscope
April 18, 2025 Scott, Mark, and Ray discuss questions that came into the PRS Helpdesk:For the past 8 months, I have been in an employed position with a county hospital system that provides inpatient and am...
UCR 238: Current Urocuff coding, how to code for the Revi, can 91122 be done in the office, and prostate cancer "active surveillance" E/M problem level
April 11, 2025 Scott and Mark discuss questions that came into the PRS Helpdesk:Hello, Some years ago we were using the SRS urocuff. Can you tell me what the current codes are? I know this has been mention...
UCR 237: Who Can Provide Billable Biofeedback Services, and Can These Services Be Billed Under Incident-to Rules?
April 4, 2025 Scott and Mark discuss who can perform biofeedback services, clarify billing requirements, and explore practical scenarios involving incident-to billing. Mark and Scott break down key Medicare guidelines...