Medical Billing for Urology

Medical Billing for Urology

Medical billing is the practice by which medical offices bill insurance companies for healthcare services provided to patients. In order to do this, billing specialists assign designated codes to different procedures to streamline the process of billing certain procedures.Urology Medical Billing

MPMR provides medical billing services for urology practices and has been working with specialty practices for two decades.

Under the ICD-10, a new system that categorizes all procedures according to a seven-digit code made up of alphanumeric characters, a procedure can be specifically categorized according to its type, what system of the body is being affected, what instruments are used when conducting the procedure, what body part is being affected, and any other qualifiers that help to pinpoint its exact purpose without actually listing a patient’s diagnosis in the code.

Character Description

Medical Billing NeurologyCharacter 1: Section

Character 2: Body System

Character 3: Root Operation

Character 4: Body Part

Character 5: Approach

Character 6: Device

Character 7: Qualifier

Billing for Urological Procedures and Services

Billing for urological services works in the same way as billing for other medical services. Beginning under the Medical and Surgery category, the billing code for urinary-related procedures begins with 0T, and will continue based upon what type of procedure is being performed.

For instance, if the procedure is to insert an artificial sphincter, a device used to help with incontinence, into the patient’s urethra, the billing code would be 0THD0LZ. The “0T” denotes that it is a surgical procedure of the urinary system. The “H” signifies that the root operation is Urology medical billingan insertion. The “D” represents the part of the body in which the root operation is taking place, in this case the urethra. The “0” indicates that the approach to the procedure is an open one.

An open approach is one in which the patient is cut open in order to perform the procedure. The “L” signifies that the device being inserted is an artificial sphincter, and the “Z” signals that there are no additional qualifiers by which to define the procedure.

The Structure of the Urological Billing Code

The urological service code differs based upon the procedure the patient is having. For example, if the patient were undergoing a right kidney repair, the code would be 0TQ00ZZ. The “0T” places the code into the category of surgical procedure of the urinary system. The “Q” designates the root operation as a repair.

The “0” signifies that it is the right kidney that is being repaired. The next “0” implies that it is an open procedure. The “Z” is there to indicate that the approach to the repair is an open approach, and the “Z” denotes that there are no other qualifiers for this procedure.Medical Billing Neurology

The completed urological code is then transferred onto a billing form which is then sent to the insurance company. The insurance company is able to convert the code to figure out how much of the procedure is covered by the specific insurance plan the particular patient has.

From there, the insurance company will pay its designated amount to the medical practice, which will then bill any remaining balance to the patient. Patients rarely, if ever, see the specific billing code that is assigned to them for any procedures they may have. It is merely for internal use.

Billing for any urological medical procedure can be difficult for those who do not know the specific codes for specific procedures. Once the pattern and the codes are known, it is easy to identify the procedure being performed, which allows billing to become simplified as well. With this coding process, the correct coding is being implemented, so that the correct procedure is being billed.

MPMR has experts in urology medical billing and has been working with urologists for two decades nationwide. If you are looking for the top medical billing company for urology, call MPMR today!

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