UCR 259: Bladder Cancer Reimbursement Strategies – Using Unlisted J Codes and the New Zusduri Hub Tools

September 19, 2025 

In this episode, Scott, Mark, and Ray Painter dive into bladder cancer reimbursement with a special focus on billing strategies for new intravesical therapies like Zusduri, which currently lack established J codes. Mark outlines the complete reimbursement pathway from diagnosis coding through installation documentation, prior authorizations, appeals, and follow-up. They discuss the importance of accurate diagnosis flow, clear drug documentation, and the nuances of billing unlisted codes—including Box 19 tips and JW modifiers.

The episode also introduces PRS Network’s new Zusduri Reimbursement Hub, including a custom J Code calculator designed to help practices manage invoicing timelines, track payment cycles, and streamline claim submissions. This tool is a game-changer for practices adopting new therapies. The Painters wrap up with reflections on the importance of payer education, the role of pioneers in improving access to innovative urology treatments, and how this supports better outcomes for patients.