Master the Complexity of
Urology Billing
Urology practices face intense scrutiny for procedural unbundling. From complex urodynamics and endourology to high-cost in-office medications, we ensure your surgical and clinical revenue is fully captured and protected.
Procedural Unbundling
We expertly apply Modifiers 51, 59, and X-modifiers to ensure you are paid for complex cystoscopies, stent placements, and stone removals performed in a single session.
Why Urology Demands Specialized Billers
Urology billing is fraught with NCCI bundling edits. When a urologist performs a cystoscopy alongside a fulguration or a prostate biopsy with ultrasound guidance, generic billers often fail to apply the correct modifiers, resulting in immediate claim denials. We deconstruct your operative reports to capture every RVU you've earned.
Cystoscopy & Endourology Edits
When performing a cystoscopy alongside a ureteral stent placement or stone lithotripsy, we expertly navigate NCCI edits, utilizing Modifiers 51, 59, or X(E, S, P, U) to ensure maximum reimbursement.
Urodynamics Precision
Urodynamic testing requires billing multiple components (e.g., cystometrogram, EMG, voiding pressure). We ensure all professional and technical components are coded without triggering mutually exclusive denials.
High-Dollar Drug Coding
In-office treatments for bladder or prostate cancer (like BCG or Lupron) require precise J-code and NDC mapping. We capture both the drug cost and the administration fee (e.g., CPT 51720) flawlessly.
Securing Revenue from
Clinic to Operating Room
We meticulously manage the full spectrum of your practice—from high-dollar in-office drug administration to complex robotic and endoscopic surgeries.
Pre-Auth for Advanced Procedures
Urology heavily relies on advanced imaging and outpatient surgeries. We secure airtight prior authorizations for robotic prostatectomies, lithotripsies, and specialized scans.
Op-Note Deconstruction
Our certified surgical coders dissect your operative notes, capturing ultrasound guidance (76942) during prostate biopsies (55700) and identifying separately billable procedures.
Global Period Management
Major surgeries like a TURP carry 90-day global periods. We expertly apply Modifier 24 for unrelated E&M visits and Modifier 78/79 for return trips to the operating room.
Surgical Denial Appeals
Insurers aggressively bundle urological codes. Our appeals team fights back using operative evidence and AUA (American Urological Association) guidelines to overturn unjust bundling denials.
Stop Leaving Surgical &
Drug Revenue Behind
Partner with elite coders who understand the exact mechanics of urodynamics, endourology edits, and high-dollar J-codes. Contact Valeria Healthcare Solutions today.