In the 2019 ICD-10-CM release, the Centers for Medicare & Medicaid Services (CMS) released a total of 473 code changes, including 279 brand-new codes. Urology is among the top specialties which have seen most of the changes. Most of the new urology ICD-10 codes for 2019 address changes for urethral strictures, urinalysis findings, and testicular diagnostic imaging.
Due to the complexity of the codes, frequent errors are noted, as follows:
- Use of modifier‐25
- Use of modifier ‐59
- Treatment of bladder neck contracture
- Complicated catheterization
- Bladder biopsy vs TURB
- Removal and closure of skin lesions
A recent Urology Times report cautions against three common mistakes that can lead to audits or retroactive review of claims and take backs:
- Use of unspecified ICD codes : For example, using C67.9 bladder cancer site unspecified. Usually urologist know the specific site of bladder cancer from where it is biopsied. As such, the procedure note should specify the site to ensure the highest level of coding.
- Using symptom codes: Misused symptom codes are another common error. Symptom codes are appropriate if:
- the patient is referred for a symptom and no specific diagnosis is made yet
- Once the diagnosis is made or the symptom is no longer present, symptoms codes should be removed.
- Assigning cancer diagnosis when the cancer has been surgically removed, with no symptoms present: Diagnosis with a personal history of malignant neoplasm is the appropriate option for patients who had treatment for prostate, testicular, kidney, or bladder cancer and had the cancer removed, and have no elevated PSA or remaining cancerous tissue. Accurate reporting will ensure accurate payment. This saves your practice from future take backs by RAC audits.
Value-based medicine programs are looking at total cost of patient care in Urology. The urologists need to improve is accurate coding of chronic urologic diagnoses. We strongly recommend using technology and mobile apps like DocCharge to assist you in coding for all relevant diagnoses for each patient, including updating any older diagnoses and adding new chronic diseases. But urologist and urology billing staff need to understand that your practice’s long-term financial health can be adversely affected by these additional patient problems.
DocCharge has recently implemented advanced search algorithm that can identify specific urologic diagnosis very efficiently during patient visits. These coding tools improve physician productivity and saves time for physicians and billers.
DocCharge mobile charge capture solution helps Urologists accurately capture charges and thus improve your productivity. If you’re interested for a FREE demo please contact us for a customized demo for your practice.