What Are The Best Practices For Urology Billing Services?

A branch of the medical field that deals with the study of medicine and physiology concerned with the functions and disorders of the urinary system. It is a quite unique specialty of the healthcare facility that also involves complex billing procedures. Since urology billing and coding for all diagnoses and treatments provided to correct the urinary systems’ dysfunctions and the male reproductive system which is the most demanded and complex procedure. However, there are some best practices that can help you scale urology billing services and boost your business growth.

Usually, healthcare practitioners just hire an internee and inexperienced high school kids for medical billing and coding. Because it doesn’t require any university degree or certification (officially/ legally) to start your career in medical billing and coding services. 

However, an inexperienced person can never assist you in providing insights into improving your healthcare revenue cycle management and boosting your business income growth. On the other hand, it becomes a more expensive and effort-intensive task to research, hire and recruit well-experienced urology billing specialists for an in-house billing department of a healthcare facility. 

Therefore, practitioners can opt for modern medical billing solutions like outsourcing urology billing services. It allows healthcare professionals to collaborate with a team of subject-matter experts at the most affordable prices.

Professional urology medical billers require specialized expertise and knowledge, a professional urology billing company can handle the nuances of your practice to deliver on-demand medical billing solutions. Since urology also tends to overlap with other specialties such as oncology, gastroenterology, andrology, pediatrics, endocrinology, and gynecology, therefore only well-educated personnel can help you navigate through billing and coding challenges.

Did you know 70% of healthcare practitioners tend to outsource urology billing services in the USA? If you want to achieve a competitive edge then what are you waiting for? Outsource urology billing services to CureCloudMD for the most reliable, efficient, and cost-effective healthcare revenue cycle management solutions. We are a US-based HIPAA-compliant medical billing company that has been helping several urologists with a complete range of urology healthcare RCM outsourcing solutions for over a decade.

As urologists focus on delivering excellent medical care, often, they lose track of their medical billing cycle. That’s why they can’t realize non-payment or underpayment on time which makes them miss out on their deadline to resubmit and appeal their payments. This increases the uncollected balance in the account receivables of urologists and impacts their revenue growth negatively as urology procedures are typically costly.

An in-house medical billing team can be helpful but may cause denials on account of the lack of expertise or resources. On the other hand, outsourcing enables healthcare providers to get better control over collections and denials because you can partner with urology billing professionals by extending your team virtually.

Table Of Contents

1. CPT & ICD codes for Urology Surgeries

1.1. CPT Code Range

1.2. Types of Surgeries in Urology

2. ICD-10 Codes For Urology Surgeries
3. Why Outsource Urology Billing Services To CureCloudMD?

3.1.  Our Expertise in Urology Billing Services

3.2. We Provide Professional Billing & Coding Team

3.3. We Are A Highly Transparent Urology Billing Company

3.4. We Provide Claim Denial Management Services

4. Applying best practices for Urology Billing & Coding 

4.1. Prior Authorization/ Pre-certification Solution

4.2. Prior Authorization/ Pre-certification Solution

4.3. Justify Medical Necessity

4.4. Verify Patient’s Coverage Plan Eligibility Criteria & Benefits Denials

4.5. Missing/Invalid CLIA number

4.6. Apply Accurate Medical Codes For The Coverage Of Your Services

4.7. Apply Medical Codes With More Specificity For Maximum Benefits

4.8. Medical Record Documentation in Billing CPT’s 51701-51703

1. Our Value

CPT & ICD codes for Urology Surgeries

Current Procedural Terminology (CPT®) codes provide a uniform coding standard (nomenclature) for coding medical procedures and services of a healthcare facility. Medical CPT codes are critical to streamlining reporting and increasing accuracy and efficiency, as well as for administrative purposes such as claims processing and developing guide. 

CPT codes are categorized based on the organs like Kidneys, Ureter, Bladder, Urethra, Male, and Female genital organs. 

CPT Code Range:

50010 – 58294 for urology surgeries. 

Types of Surgeries in Urology: 

• Incision/Biopsy
• Excision
• Transplantation
• Catheter introduction
• Laparoscopy
• Endoscopy (Cystoscopy, Urethroscopy, Cystourethroscopy, etc.,
• Repairs

ICD-10 codes For Urology Surgeries

The International Classification of Diseases (ICD) is designed to promote international comparability in the collection, processing, classification, and presentation of mortality statistics. This includes providing a format for reporting causes of death on the death certificate. 

ICD-10 codes should be used based on the LCD guidelines to avoid insurance deniasl. ICD-10 codes being used by our coders while coding for urology surgeries are as below; 

• C00 – D49 – Neoplasm
• E00 – E89 – Endocrine, nutritional and metabolic diseases
• N00-N99 – Diseases of the genitourinary system
• Q50-Q56 – Congenital malformations of genital organs
• R30-R39 – Symptoms and signs involving the genitourinary system

Why Outsource Urology Billing Services To CureCloudMD?

CureCloudMD is a US-based HIPAA-compliant medical billing company offering professional, compliant and cost-effective urology billing and coding services. Our client bas extends across all 50 states and includes different healthcare entities, including hospitals, physician practices, and labs. 

Our Expertise in Urology Billing Services

CureCloudMD is a well-experienced urology billing company that provides a complete range of healthcare revenue cycle management solutions including; 

• Prior authorization & insurance eligibility verification services.
• Urology medical billing services. 
• Medical coding services. 
• Account Receivable (AR) recovery services. 
• Claim denial management services. 
• Medical credentialing services. 

We Provide Professional Billing & Coding Team

We hire well-experienced and educated medical billers who are well-versed with the nuances of urology practice. We also expand our team to meet the growing staffing needs of your practice. 

Our Certified Urology Coder (CUC) medical coding team are proficient in ICD-9/10, CPT, HCPCS coding according to CMS and AMA guidelines. Our medical billing professionals have 10+ years of extensive experience in urology billing and coding services. 

With professional expertise and professional experience, our team helps you scale your revenue growth by streamlining your billing procedures. We work as a virtual extension of your in-house medical billing team supporting and guiding at every step of urology healthcare revenue cycle management. 

We Are A Highly Transparent Urology Billing Company

CureCloudMD helps you get better insights into your healthcare revenue cycle management and control your finances with real-time analytics. More often some healthcare practices can never track if their bills are paid completely or if their denials are appealed or not. 

While we prepare real-time reports of your medical bills, claims submitted, claim denials, reimbursements received and outstanding balance. Also, we regularly submit these reports to our clients. So they can stay engaged with their medical billing cycle and keep a track record of the payments. 

We Provide Claim Denial Management Services

According to a study, several healthcare practitioners miss out on their hard-earned revenue because they don’t respond to their denied/rejected claims and resubmit them on time. It could be due to the loss of track record of claim denials and rejections, late submitted medical bills, or inefficient urology billing services. 

Therefore, our medical billers monitor errors and mistakes within your medical billing and coding procedures. We address claim denials and rejections on time to resubmit your claims and appeal your uncollected reimbursements. In this way, we contribute to the significant revenue growth of your business with on-demand claim denial management solutions. 

Now you’ve learned that innovative urology billing solutions can help you get a competitive edge and boost your business productivity. However, you have to adopt the best practices for urology billing services in order to make sure that you’ve adopted the right solution. 

Applying best practices for Urology Billing & Coding 

Whether you recruit in-house urology billing specialists or want to outsource urology billing services, you have to adopt some essential parameters to make sure that you’re applying the best practices for urology billing and coding services. It will help you gauge all the KPIs and you can make sure that your business is scaling up at high levels. 

Especially, if you want to outsource urology billing services then make sure that the medical billing company has the following traits; 

• The medical billing company is HIPAA-compliant.
• The agency must perform regular medical billing audit to monitor mistakes, eliminate errors and streamline your billing procedure. 
• The medical billing company must have expertise in CPT, ICD-10, & HCPCS codes. 
• They must have expertise in modern medical billing and practice management software solutions. 
• They must provide claim denial management and account receivable (AR) recovery solutions to help you recover your lost revenue. 

Along with this checklist, make sure that the urology billing company adopts the following best practices for urology billing and coding services as follows; 

Best Practices in Urology Billing & Coding

Prior Authorization/ Pre-certification Solution:
As urology procedures are pretty expensive, therefore, healthcare providers should obtain prior authorization from the insurance company before rendering the services. Several healthcare insurance companies require prior authorization to cover the patient’s medical care. If not provided, the insurance company will deny your reimbursements. 

Prior authorizations help practitioners understand the submission guidelines better, submit medical claims on time, and get reimbursement instead of denials. 

Justify Medical Necessity: 

It is essential that the urologists should be able to justify the medical necessity of the course of treatment to be able to get paid for the highly expensive services they provide. 

Verify Patient’s Coverage Plan Eligibility Criteria & Benefits Denials:

It is the responsibility of the registration staff of a healthcare practice to verify the patient’s coverage plan eligibility criteria before rendering medical care services. Usually, patients aren’t well-informed if their current plan covers the following medical procedure or lab test. 

Let’s say a patient has changed their job or residential address, then the coverage plan changes according to the new employment plan, and state. But some patients don’t realize these changes so it is the responsibility of the patient registration staff to verify and validate the patient’s insurance eligibility criteria. Make sure to proceed with the verification and validation procedure 48 hours prior to delivering the services to reduce claim denials. 

Executing prior authorization and verification of the coverage eligibility criteria enables you to ensure accuracy down the line in your medical billing system. 

Missing/Invalid CLIA number (Clinical Laboratory Improvement Amendments): 

It is important to update the CLIA number to prepare medical bills for the lab test. 

Apply Accurate Medical Codes For The Coverage Of Your Services:

During the preparation of medical bills, make sure that the medical coders apply accurate medical codes that are recognized and covered by the relevant insurance payer. 

For example, Medicare will not pay for A codes like A4357, A4334, A5114, A4340, A4331, etc., and deny as Non-Covered Services while other insurance companies pay for the Medicare non-covered services. 

Apply Medical Codes With More Specificity For Maximum Benefits:

The medical coders should apply CPT codes with the correct units as recognized by the specific payers for specific CPTs. For example, Payers will deny CPT codes 51700, 52300, 52310, 55876, and 77263 if we bill for more than one unit.

Moreover, urology coding specialists should apply accurate modifiers to highlight the specificity of the medical procedure according to the standard guidelines. For example,  providers must use modifier 59 when billing for two urology services together

Medical Record Documentation in Billing CPT’s 51701-51703. 

Urology coding specialists should not report 51701-51703 alng with any other procedure that includes catheter insertion as a component. 

Our Value

CureCloudMD aims to deliver compliant, reliable and on-demand urology billing and coding solutions to help healthcare providers deliver quality patient care services. We assist providers with revenue growth and empower their finances to help them achieve revenue goals with streamlined urology billing services. 

We apply our experience in urology billing and coding to rectify, improve, and achieve a dynamic, denial-free revenue cycle management. Our team of experienced urology billing specialists focuses on improving your collections so you can expand your practice to cater to a larger volume of the patient base with satisfactory and quality medical care services. 

Upon finding out that it is pretty expensive and a time-intensive task to hire experienced urology billing specialists. We are here to help practitioners with a professional team of urology billing and coding services at a fraction of your existing IT expenses. 

Our certified urology coding specialists have been successfully processing medical claims with most commercial insurance companies including UHC, Wellpoint, Aetna, Humana BCBS, and Anthem, and government payers such as Medicare & Medicaid for a broad client base of CureCloudMD. 

We provide fully compliant and regulated medical billing services according to Medicare & Medicaid guidelines and incompliance with state-specific Medicaid Policies. 

Also, we are providing a free pre-onboarding medical billing audit to all clients. So you can better insights into your healthcare revenue cycle management and identify the loopholes within your medical billing cycle. However, this offer is available for a limited time for all healthcare providers. 

Don’t miss out on the chance and schedule your free medical billing audit with CureCloudMD right. We provide a comprehensive suite of urology billing and coding services at the best prices. 

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