The Urology Coding and Reimbursement Podcast is for Urologists and urology practice staff: Administrators, APPs, Billers and Coders. We help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life. Your cohosts, Mark, Scott and Dr. Ray Painter discuss urology coding and share best practices for the urology office. We will answer submitted urology coding questions so that you can learn the concepts and apply in your practice. Learn the best practices: urology coding, revenue cycle management, scheduling, collections, patient information collection, pre-authorization, prior approval, charge capture, office communications, claim entry review, appeals, audits and billing, that we have tested and proven so you can adapt and incorporate.
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Urology Coding and Reimbursement Podcast is a health podcast hosted by Unknown Host, with 298 episodes on record and a Required Pod Score of 80. PitchCentric scores this show on Booking Probability, Listen Score, and live audience signals refreshed every 24 hours.
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Unknown Host hosts Urology Coding and Reimbursement Podcast, a health show with 298 episodes published.
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Episode #300
UCR 300: Collecting From Patients – Getting Paid When the Patient Is the Payer
Aug 14, 202627 min
August 14, 2026 In this episode, Scott and Mark Painter revisit ABNs and the growing importance of collecting directly from patients as more financial responsibility shifts away from payers. They discuss when ABNs are appropriate, cash-pay options, co-pays, deductibles, co-insurance, surgical deposits, and the value of collecting before services are rendered. The conversation also explores how practice culture, staff training, front-desk policies, geography, and patient demographics can influence collection success. The key takeaway: strong patient collection processes are no longer optional—they are a critical part of protecting the financial health of a urology practice. PRS Coding and Reimbursement Hub Access the Hub Botox LCD Alert Download the Alert Free In-Office Prostate Biopsy Calculator (Suppoted by UC-Care) Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner. https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/
UCR 299: Listener Questions Answered — Billing for Radiological Services with Office Visits, Stone Diagnosis Coding, and Modifier 25 Denials
Aug 7, 202630 min
August 7, 2026 In this episode, Scott, Mark, and Dr. Ray Painter answer three reimbursement questions involving common—but increasingly scrutinized—coding situations. First, they discuss when a urologist can separately bill the professional component of a radiologic service such as retrograde urography on the same day as an E/M service, including the documentation requirements and potential conflict when radiology also bills for the interpretation. Next, they examine a ureteroscopy denial caused by an inconsistent diagnosis code and explain how to properly distinguish kidney and ureteral stones with and without hydronephrosis. Finally, they tackle another modifier 25 denial and explain why simply citing NCCI rules in an appeal may not be enough—the documentation must clearly demonstrate the significant, separately identifiable E/M service that supports the modifier. PRS Coding and Reimbursement Hub Access the Hub Botox LCD Alert Download the Alert Free In-Office Prostate Biopsy Calculator (Suppoted by UC-Care) Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner. https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/
UCR 298: Listener Questions Answered — Floor Consults Leading to Surgery, Pelvic Lymphadenectomy Denials, and Bladder Stone Removal During Simple Prostatectomy
Jul 31, 202635 min
July 31, 2026 In this episode, Scott, Mark, and Dr. Ray Painter answer three detailed listener questions. First, they discuss whether an E/M service can be billed when a urologist evaluates a patient on the hospital floor and then decides to take the patient to the operating room for stone treatment or stent placement. Next, they examine payer denials involving laparoscopic radical prostatectomy with bilateral pelvic lymphadenectomy and whether all listed lymph node groups must be removed to support code 55869. Finally, they explain how to report bladder stone removal performed through the same laparoscopic incision as a simple prostatectomy—and why the surgical approach may require an unlisted bladder procedure code. PRS Coding and Reimbursement Hub Access the Hub Botox LCD Alert Download the Alert Free In-Office Prostate Biopsy Calculator (Suppoted by UC-Care) Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner. https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/
UCR 297: UTI PCR Coding Changes, Audit Risk, and the 2027 RVU Winners and Losers
Jul 24, 202636 min
July 24, 2026 In this episode, Scott, Mark, and Dr. Ray Painter examine a major shift in Medicare’s approach to coding UTI PCR testing. The discussion explains why reimbursement may now depend on the number of testing kits, methodologies, or procedures used—not simply the number of organisms reported—and what practices should review with their laboratory partners. The team also addresses denials, RAC and UPIC audits, corrected claims, potential commercial payer takebacks, and the continuing uncertainty in MolDX states. They then review the proposed 2027 RVU changes affecting urology, including a significant increase for in-office bulking agent injections, potential reductions for urodynamics, and additional changes to prostate biopsy codes. PRS Coding and Reimbursement Hub Access the Hub Botox LCD Alert Download the Alert Free In-Office Prostate Biopsy Calculator (Suppoted by UC-Care) Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner. https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/
UCR 296: 2027 Medicare Proposed Rule – The Changes That Matter Most to Urology
Jul 17, 202637 min
July 17, 2026 In this episode, Scott and Mark Painter provide their initial analysis of CMS's proposed 2027 Medicare Physician Fee Schedule and highlight the changes most likely to impact urology practices. The discussion covers the proposed conversion factor reduction, a significant new proposal to apply the multiple procedure payment reduction to E/M services billed with modifier 25, changes to G2211, updates to practice expense methodology, prostate biopsy coding revisions, telehealth proposals, and a substantial reimbursement increase for bulking agent injections. The team also shares practical insight into what these proposals could mean for physician compensation, practice operations, and future commercial payer policies. The key takeaway: while the rule is still only proposed, now is the time for urology practices to understand the changes, submit meaningful comments, and begin planning for what could be a very different reimbursement landscape in 2027. PRS Coding and Reimbursement Hub Access the Hub Botox LCD Alert Download the Alert Free In-Office Prostate Biopsy Calculator (Suppoted by UC-Care) Download Now PRS Coding Courses For Urologist For APPs For Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer Group Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner. https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group. The Thriving Urology Practice Facebook Group link to join: https://www.facebook.com/groups/ThrivingPractice/
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