The Do’s & Don’ts Of Urology Coding Services? Basic Guidelines

Urology is a unique field of the healthcare industry that constitutes specialty-specific medical coding regulations. Urologists should make sure that they capture charge for their time, efforts, and equipment used to treat patients for medical therapy and diagnostic services with accurate codes in compliance with standards defined by regulatory institutes.

It is the most complex task for healthcare providers to comply with the ever-changing coding rules. However, there are some strategies that can help urologists efficiently use medical codes and stay safe from mistakes that cause incorrect medical codes, and avoid claim denials. 

In this article, I have listed down the basic guidelines for urology coding services to take the guesswork out for you. If you are initiating a startup or want to learn about urology medical codes then this guide will help you select the accurate medical codes more efficiently. 


Use accurate medical codes in less them with the help of following strategy; 

  1. E/M Codes: E/M also referred to as Evaluation and Management codes. These codes are found between 99202 and 99499 which is used to prepare bill for the services of physicians and nonphysicians practitioner clinic visits, hospitals and consultations. 
  2. Procedure Codes: These codes are usually found between 50010 and 58999 which are used to bill the payments for diagnostic and treatment services. 
  3. Add-on Codes: these are found are used to identify the procedures that are carried out along with the primary urology procedures. These codes are designated with the “+” symbol in the CPT manual. If you’ve reported the right primary procedures along with add-on codes then you can get paid completely for your hard-earned urology services. 

Now, when you are familiar with the general categories of urology codes and how to find them then you can easily select the right code for the charge capturing of your services. Once, you are clear what type of medical codes are accurate for your services then you can easily pick up the medical and diagnoses codes from the chart notes. 

Also, you can translate your services into standard codes with the complete details of tha patient on that date of service (e.g. Diseases of the Genitourinary System are ICD-10 codes from N00-N99). 

Pay Attention To The Trivial Details To Use Specified Urology Codes

In some cases, when urology coding specialists don’t sweat the small stuff then it also leads to wrong coding cases (upcoding & undercoding). In order to avoid such situations, you should always document and verify every essential detail of the medical procedure performed on the patient. 

For example, if you have delivered a medical therapy for bladder cancer diagnosis then check out the procedure notes to verify the location from which the bladder tumor was removed. Mostly, urologists make a common mistake here and over C67.9 in which bladder cancer remains unspecified. 

An unspecified diagnosis should only be used when you don’t receive the complete information to assign a more specific code (which is a very rare case practice in the healthcare environment). Usually, you will have complete information about the medical and diagnostic procedures performed on the patient. Always remember, that if you would not use a specific CPT, ICC-9/10, HCPCS code or modifier then the clearing house will reject your claim right away. 

More Examples of Specific Codes

C67.2 Malignant neoplasm of lateral wall of bladder

C67.3 Malignant neoplasm of anterior wall of bladder

C67.4 Malignant neoplasm of posterior wall of bladder

C67.5 Malignant neoplasm of bladder neck

You can avoid the revisions and duplication of work by simply verifying every piece of information in the documentation. Urology coding specialists should make sure that they must have proper documentation that supports the medical codes and modifiers in their medical bills. 

Do’s & Don’ts of Urology Coding For Error-Free Medical Billing Services

Always Manually Check to Verify Your Codes

We suggest you don’t take the risk to determine procedural or diagnostic codes from the EHR code suggestion feature. The urology coding and billing specialists should create a point of contact with the providers to communicate every detail about the services delivered. So they can review the documents and select the most accurate medical codes and modifiers. 

On the other hand, automated solutions or EHR coding suggestion features can only suggest accurate codes but they can’t analyze the situation and make decisions. 

Always Rely On Professional Urology Coding Specialists

The source of primary data for medical coding services is the provider’s documentation. Therefore, urologists and their medical staff should learn how to accurately and efficiently document everything from patient registration to the services delivered. 

Urologists should also be aware of how the medical billing and coding procedures are executed so they can get a broad vision of their practice. Since medical billing and coding specialists are not well-aware of the nuances of clinical terms in urology, therefore, providers should involve in the selection and reviewing procedure of medical claims.

Although, it will be an easier solution for an independent urologist, clinic, or a small-sized practice where healthcare providers have enough time to coordinate with the medical billing and coding team. However, it’s quite the opposite for hospitals and large-sized healthcare practices where hundreds of thousands of medical claims are filed each day. 

Therefore, urologists should always rely on such medical billers and coders who ave sufficient knowledge of clinical terms involved in urology. For example, CureCloudMD is a well-experienced medical billing company that offers specialized urology billing and coding services to assist you in your practice’s growth. 

Our medical billing specialists have been helping several urologists to submit accurate medical claims and receive full reimbursements for their practice. 

Don’t UnderCode Your Services To Avoid An Audit

Undercoding is the practice when a healthcare provider selects medical codes that pay less amount than the value of the actual service delivered to the patient. Mostly, any healthcare provider doesn’t undercode their service deliberately. However, usually, it happens due to negligence or ignorance of the urology medical coder. 

Although, in some cases, practitioners tend to undercode their services purposely to reduce the chance of a financial audit. In fact, undercoding results in lost revenue because your work isn’t reported to the insurance companies the right way. 

It also results in wrong data patterns that cause problems during other business decisions down the line. Undercoding is a big red flag for Medicare because they actively investigate such cases and penalize healthcare providers for fraudulent activities. 

The best way to avoid these scenarios is to stay compliant with legal standards and educate your medical billing and coding staff to adopt the best practices. 

If you’re in search of a reliable medical billing company that offers reliable urology billing services at the best price then partner with CureCloudMD. When you outsource urology billing and coding services then our team work as a virtual extension of your office to assist and guide your staff at every step of urology healthcare revenue cycle management. 

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