decisionhealth Newsletters, Coder Pink Sheets - 2005 Issue 1 (January)
Five tips to avoid a potential 13% cut revenue in 2005
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Article Overview
This premium article reviews general revenue-protection strategies for urology practices in the context of projected 2005 payment reductions. It covers documentation-focused E/M issues, preoperative exam billing considerations, radiology and ultrasound billing concerns, drug reimbursement pressures, and the use of selected modifiers in a urology practice setting. The piece is aimed at urologists, coders, billers, and practice managers who want to understand the broad areas where coding and reimbursement changes may affect collections.
Why This Topic Matters
Urology practices needed to understand how coding, documentation, payer policy, and drug pricing could affect reimbursement during a period of expected Medicare-driven revenue decline.
Article Sections
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E/M coding
Discusses documentation and evaluation-and-management coding issues relevant to urology practice. Focuses on broad charting and review-of-systems concerns.
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Preop exams
Covers billing considerations related to preoperative examinations and when these services may be handled by another provider.
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Radiology codes
Reviews radiology-related billing concerns in a urology setting, including payer contract issues and documentation for imaging services.
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Drugs
Addresses reimbursement pressure related to medications used in urology practice and the impact of pricing negotiations.
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Modifier -22
Discusses general modifier use when additional work is associated with a procedure and the administrative effort involved in submitting the claim.
What You Will Learn
- The main reimbursement pressure points affecting urology practices in the period discussed
- Common documentation topics that influence evaluation-and-management reporting
- General payer and contract issues related to radiology and ultrasound services
- How drug pricing concerns can affect practice revenue
- The broad circumstances in which a selected modifier may be considered for additional work
Who Should Read This
- Urologists
- Medical coders
- Billing specialists
- Practice managers
- Revenue cycle staff
Codes Discussed
Modifiers Discussed
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