the importance of accuracy in urology coding


Coding is the process of identifying descriptive terms and codes for diagnoses and medical services. These are generated from interacting with patients and other healthcare providers.  This information is gathered and then organized in alpha and/or numeric order that can then be used for charge submission, performance measurements, and data collection for emerging technology, services, and procedures.  Under the Health Insurance Portability and Accountability Act, The Department of Health and Human Services designated the International classification of Diseases and Current Procedural Terminology as the national standard code sets for healthcare professional services and procedures.

Although daunting medical billing methods are one of the most critical functions of your Urology practice.  Urology Medical coding and Urology medical billing both are terms used to refer to a set of standards and guidelines that are used to characterize what has been treated and how it was handled.  Among the many aspects of your medical practice documentation is key.  Accurately recording then transcribing that documentation into the proper codes, modifiers, and extensions help create a seamless function of proper revenue stream for the practice by reducing claim rejections and denials.  Denials however can be one of the many issues Urology practices face and failing to take safeguards to prevent denials can be costly to your practice.

Stay on top of Urology coding updates

Yearly the American Medical Association (AMA) makes new changes to the Current Procedural Terminology (CPT) codes, and it is vital to make sure your practice stays current on the most advanced coding updates.  Coding is an integral business skill that an Urology must develop and cannot be reiterated enough.  Coding is the systematic way you transcribe what you treated and how you treated in order to be paid.

Urology documentation

Documentation is critical to your Urology practice and correctly interpreting this information and transcribing it into proper codes cannot be stressed enough.  We will begin with Evaluation and Management(E&M) services new and established patient visits and consultations.  Remember moving forward coding is rule based.  Therefore, E&M documentation has strict and specific criteria that determine the level of visit performed, including the location that the service is performed.  E&M service has three key components: history, physical examine, and medical decision making.  The guidelines for each of these areas are found in the Current Procedural Terminology (CPT) codebook.  The detail included in the note needs to match the level of E&M service reported.  The physical examination must be performed and documented by the individual recording the visit.  It is recommended at this time labs and tests are documented in the medical decision-making portion.  Lastly, the assessment and plan should be thoroughly summarized.  This area of CPT coding is most complex.

Urology Modifiers

A modifier is a 2-digit code that furthers defines a CPT code.  Modifiers are used to communicate additional information to the payer and are applied for many reasons including but not limited to a return to the operating room for a related procedure or an E&M service that includes the decision for surgery.  Modifiers are designed to be used with either an E&M or a procedure code.  Memorizing all the possible modifiers is difficult, but you should be aware of all the different reasons that a modifier may be needed to complete a code.  When put to use properly, modifiers can bring accuracy and detail to the record of the transaction.

Shining a light on mental health

Hold on. That is what I continually tell myself as I navigate through life. I have had more than my share of life-altering setbacks and have had people, including therapists, ask how I am still standing? It is not until recently that I can say it is because I tell myself to hold on. Many times, when the world feels as though it is caving in on me, I make it to bed and tell myself tomorrow is a new day, a fresh start, a new beginning. I can’t express how challenging life became holding it ALL in. I felt isolated, as though I was the only one or no one would understand. I slowly learned I am not the only one, and although you may not fully understand, it is my story and my feelings, and they matter! I began letting others in by going to therapy, al-anon, and opening up. I have learned that I definitely am not the only one. EVERYBODY has a story EVERYBODY hurts. So why? Why is it that, as a country in this day and age, we shut down/feel shame when we talk about mental health? There is a realm of mental illnesses, including depression and anxiety, yet when we say mental illness, we conjure up horrific thoughts and don’t discuss it. We go into a shame spiral. Again, why do we do that? Everyone feels sadness, grief, and even passing feelings of hopelessness or despair; they are all part of the human experience.


Here are just a few facts from the National Alliance on Mental Illness (NAMI)

Statistics show that one in four adults experiences an episode of mental illness per year.

Mental illness can affect persons of any age, race, religion, or socioeconomic status.

Individuals diagnosed and undiagnosed with mental illness are those around us- our neighbors, our friends, family, and co-workers.

In the United States, four million children and adolescents suffer from a severe mental disorder that causes significant functional impairments at home, school, and with peers.

Mental health disorders account for more disability than any other illness, including cancer and heart disease, reports the Centers for Disease Control and Prevention (CDC)

NAMI, the National Alliance on Mental Illness, is the nation’s largest grassroots mental health organization dedicated to building better lives for millions of Americans affected by mental illness.

What started as a small group of families gathered around a kitchen table in 1979 has blossomed into the nation’s leading voice on mental health. Today, NAMI is an association of hundreds of local affiliates, state organizations, and volunteers who work in our community to raise awareness and provide support and education to those in need. All of the services and programs that they provide are FREE! One voice at a time! We as a society need to start talking to remove the stigma of mental health. We help one another when we begin chatting.

Integrity C.A.R.E.S.

At Integrity billing, we believe mental health awareness lies within every community, which is why we are a Silver Sponsor. Integrity Billing is a top donor/team participating in the NAMI Walks 5k Walk/Run yearly. Team Integrity C.A.R.E.S. was created by Lorinda Yorlano.  Lorinda was our team’s driving force, and NAMI was a program she loved, supported, and believed in. Lorinda had a dual diagnosis of depression and substance abuse and passed in 2019, and we walk in memory of her. Help us end the stigma of mental illness. Help us today by sharing, opening up, and starting to talk.

All donations are appreciated and make a difference! You can help us reach our goal. Again, NAMI’s programs are all free. Your donation helps raise awareness of mental illness and also helps support our local organization to empower persons with mental illness and their families so they can continue to receive all programs at no cost. Visit our team page at Help us support NAMI in the hope that we can replace ignorance, stigma, and hopelessness with knowledge, empathy, and understanding.

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You shouldn’t feel like you’re gambling when submitting your behavioral health claims. Unfortunately, that is exactly what it can feel like when trying to obtain payments for services rendered in the behavioral health billing industry.  Much like playing roulette, the insurance companies like to play a game of odds, hoping that you will give up on denied claims, even when a service should be covered.  It seems that the odds are always tipped in the payer’s favor.  There is a saying in the world of gambling: “The house always wins.”  While that is true in gambling it does not necessarily mean that this needs to be the case in the for your treatment center billing.

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