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UCR 145: Complication modifier (-78) POS discussion; FAQs - laparoscopic evaluation ureter, E/M and therapeutic injection (ADT) in the same visit, code for stone removal using forceps - no cysto

 May 19, 2023 

Mark, Ray, and Scott talk about a question Dr. John Lin asked on a recent Noridian Mac Call about billing a Modifier -78 with POS 11 (hear the recording on the Thriving Urology Facebook Group).  Also, they answer 3 questions that came into the Urology Coding and Reimbursement Group.

  1. Robot-assisted Laparoscopic Evaluation of LEFT Distal Ureter:

    How would you code this? dr put 50949.

  2.  Hello,

    We have a question for your regarding ADT injections/visits for:

    Eligard injection- HCPCS: J9217
    Camcevi injection-HCPCS: J1952

    We have recently hired an experienced NP to launch an Advanced Prostate Clinic. For our pts on ADT therapy, can they be seen by our NP and bill a level 3 or 4 office visit as she will be discussing bone health, sexual health, and incontinence issues?

    What are other clinics doing nationwide for this type of visit and what is appropriate/recommended? Please let me know if there is any additional information I can provide.

    I really enjoy your webinars, thank you so much for providing this service!

    [To clarify, this would be for an E/M and therapeutic injection (ADT) in the same visit? ]

    Thank you,


  3. Is there a cpt code for removal of a urethral stone using forceps, no cysto involved?  Every code I see is for cysto with removal. Can we bill a 52310 with a modifier 52 for reduced services? Or should we use unlisted code 53899?  

    Thank you!

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