General Surgery Coding Alert - 2015 Issue 2
Focus on the UroLift® Reimbursement Impact
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Article Overview
This article discusses reimbursement for UroLift procedures and how payment varies by place of service, with attention to Medicare fee schedule valuation, RVU-based calculations, and the practice cost impact of devices and implants. It is aimed at urology practices, coders, and billing staff evaluating whether in-office performance is financially viable and how reported procedure codes relate to reimbursement analysis.
Why This Topic Matters
Urology practices need to understand how reimbursement and supply costs affect the financial performance of UroLift services in different settings. The article helps readers assess billing and profitability considerations tied to Medicare payment methodology and practice expense components.
Article Sections
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Reimbursement context and practice impact
Introduces the reimbursement issue for UroLift services and frames the question of practice profitability. It discusses why payment analysis matters for office-based performance.
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Review the Numbers
Presents a payment comparison using RVU-based calculations and different sites of service. The section focuses on how reimbursement is evaluated using current fee schedule information.
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Analysis
Explains the practice expense impact of device costs and the overall financial effect for a procedure involving multiple implants. It summarizes the cost and reimbursement relationship discussed in the article.
What You Will Learn
- How the article approaches reimbursement analysis for UroLift procedures
- Why place of service affects payment review
- How RVU-based calculations are used in the article's financial comparison
- What practice-level cost factors are discussed in relation to implants and delivery devices
Who Should Read This
- Urology practices
- Medical coders
- Billing staff
- Practice managers
- Revenue cycle staff
Codes Discussed
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