Stephanie N. Stinchcomb, CPC, CCS-P, ACS-UR
Urology practices know that denials & requests for more information from payers are an increasing problem. You might code the claim correctly, but you still find the claim returned/denied. Don’t just write off the denial – find out how to combat denials for key services in your urology practice including ultrasounds, urodynamics, renal ablation procedures, and much more.
Join urology coding expert Stephanie N. Stinchcomb, CPC, CCS-P, manager of reimbursement in the regulation, reimbursement and quality department of the American Urological Association to learn how to fight denials for your urology claims. Here’s just a sampling of some of the denials Stephanie will discuss:
- Prostate biopsy for patients with private insurance: You’re probably getting a denial for the second ultrasound. You’ll get paid for 76872 or 76942 with 55700, but not both. Get step by step details on how to appeal that denial.
- Transurethral incision of the prostate denied by Medicare as “investigational”: A viable surgical intervention for patients with LUTS and benign enlargement of the prostate, equivalent in symptomatic relief to a transurethral resection of the prostate. Find out how to turn the denial into pay.
- Urodynamics testing: Payers often deny, saying the “batteries” in which many tests are performed are lacking medical necessity. In some cases, payers simply decide one CPT code can substitute for another, and bundle them. Learn how to reverse that trend in your practice.
- Plus much more – including tested tips to fight denials for:
- Renal ablation procedures
- Ultrasound procedures
- Post-void residuals with E/Ms
- Urinalysis
Bonus – Get examples of the letters you can adapt and send into your payer so you can overturn those denied procedures.
With your practice’s costs on the rise and reimbursement from Medicare and private payers facing an imminent decline, your practice can’t afford to leave even a dime on the table. Every procedure brings in valuable reimbursement, which means one coding blunder could equal a costly error. It is more important now then ever to ensure you get maximum reimbursement for key services in your urology practice.
