PRSnetwork

03/24/2026

🔍 Modifier -25 Confusion? We’ve Got Answers!
If a patient returns for a routine SPT change or Lupron injection and the provider notes “return in a week/month for the next change,” is that enough for a -25 modifier to be billed? 🤔
🎧 Get clarity on this common scenario in Episode 181 of the PRS Network podcast at 16:58! https://www.prsnetwork.com/181

Urologists and urology practice staff: Administrators, APPs, Billers and Coders Unite! Your co-hosts, Mark, Scott and Dr. Ray Painter are on a mission to help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life.

03/23/2026

🎙️ New Episode: Urology Coding and Reimbursement Podcast

A new UnitedHealthcare documentation rule could impact how practices get paid—and MDM data rules continue to raise questions.

In this episode, Scott, Mark, and Dr. Ray Painter break down:
• UnitedHealthcare’s new documentation requirements for diagnostic services
• How external records count toward MDM data
• Whether interpreters qualify as data points

🎧 Listen now: https://www.prsnetwork.com/281

Are these changes affecting your workflow or reimbursement? Share your experience below 👇

Urologists and urology practice staff: Administrators, APPs, Billers and Coders Unite! Your co-hosts, Mark, Scott and Dr. Ray Painter are on a mission to help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life.

03/20/2026

🎙️ New Episode: Urology Coding and Reimbursement Podcast

Are testosterone pellet therapies being denied more often? Are secondary payers adding unexpected prior auth hurdles? And can urology questionnaires actually be billed as health risk assessments?

In this episode, Scott, Mark, and Dr. Ray Painter break down:
• Testosterone pellet (Testopel®) denial trends
• Secondary payer prior authorization challenges
• Billing considerations for urology risk assessments

🎧 Listen now: https://www.prsnetwork.com/280

What reimbursement challenges are you seeing in your practice? Let us know below 👇

Urologists and urology practice staff: Administrators, APPs, Billers and Coders Unite! Your co-hosts, Mark, Scott and Dr. Ray Painter are on a mission to help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life.

03/20/2026

💡 Coding Clarification Alert!
A PRS Network client recently asked about the correct CPT code for a robotic ureteroneocystostomy with vesico-psoas hitch. Should you use 50948 or go unlisted? 🤔
Tune in to Episode 181 at 10:35 to get expert guidance! 🎙️
📌 Don't miss this practical tip for improving your coding accuracy.
🎧 Listen now: https://www.prsnetwork.com/181

Urologists and urology practice staff: Administrators, APPs, Billers and Coders Unite! Your co-hosts, Mark, Scott and Dr. Ray Painter are on a mission to help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life.

03/18/2026

💡Can APPs Perform Procedures in the Office?
We’ve been getting a lot of questions about whether APPs can perform procedures like 51720, 95972, and Eligard/Firmagon injections on their own in the office. In most cases, yes — as long as the procedure isn’t considered surgical and the APP is a qualified healthcare provider under payer rules.

🎧 Tune into Episode 181 at 14:10 for a deeper dive into the guidelines and what to check in your state and payer policies. https://www.prsnetwork.com/181

Urologists and urology practice staff: Administrators, APPs, Billers and Coders Unite! Your co-hosts, Mark, Scott and Dr. Ray Painter are on a mission to help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life.

03/17/2026

📢 PRS Network Live Online Monthly Webinar Series: Optimizing Income & Efficiencies for Urology Practices
🔍 This Month’s Topic: Prostate Biopsy Coding: Early Lessons from the New Coding Rules
📅 When: Thursday, March 19th⏰ 1:30 PM Eastern
➡️ Register Here:

*Register once to be emailed a unique link for access to all webinars in this series. Bookmark your unique link for easy monthly access.

03/13/2026

🩺 Coding confusion? You're not alone.
One of our attendees asked this during the seminar:
👉 “For an initial hospital consultation, I’ve been using 99223 and generally 99232 for follow-up visits. Is that correct?”

We tackled this exact question in Episode 181 of the PRS Podcast at 4:30.
🎧 Tune in to get the correct CPT coding guidance and avoid costly mistakes!
📲 Listen now: https://www.prsnetwork.com/181

Urologists and urology practice staff: Administrators, APPs, Billers and Coders Unite! Your co-hosts, Mark, Scott and Dr. Ray Painter are on a mission to help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life.

03/10/2026

🎙️ **Podcast 279: LCDs, NCDs, LCAs, and Audits — Understanding Medicare’s Coverage Landscape**

In this episode, Scott, Mark, and Dr. Ray Painter unpack the complex *“alphabet soup”* of Medicare coverage and auditing tools—including **NCDs, LCDs, LCAs, RAC audits, and the emerging WISER program**.

Prompted by a new **multi-state LCD affecting Botox coverage**, the discussion explains:
• How coverage determinations are created
• How Medicare contractors enforce them
• Why documentation requirements continue to expand

The panel also shares how practices can adapt by developing workflows, intake forms, and clinical documentation processes that capture the data Medicare expects—helping physicians navigate audits while still delivering appropriate patient care.

Listen here:

Urologists and urology practice staff: Administrators, APPs, Billers and Coders Unite! Your co-hosts, Mark, Scott and Dr. Ray Painter are on a mission to help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life.

03/02/2026

🎥 Now Available On-Demand: ZUSDURI™ (mitomycin) for intravesical solution – Billing & Coding Webcast Recording

Missed the live session? You can now watch the recording at your convenience.

This educational webcast is designed to help your team strengthen compliance, prevent denials, and achieve accurate, efficient reimbursement for ZUSDURI™ (mitomycin) for intravesical solution.

🔎 What’s covered:
✔ Key documentation requirements to support medical necessity
✔ ICD-10 coding considerations
✔ Prior authorization strategies to reduce delays and denials
✔ Transition from unlisted codes to the new J-code (effective January 1, 2026)
✔ Proper reporting of drug waste & JW/JZ modifier use
✔ Reimbursement fundamentals, including ASP-based payment
✔ Common payer pitfalls—and how to avoid them

🎓 Featuring:
Mark N. Painter
Jonathan N. Rubenstein, MD

Watch on your schedule:
https://event.on24.com/wcc/r/5177304/1496E72A443C0CD717A0BBD306167E77?partnerref=PRS

Help your team stay compliant and prepared for 2026.

02/27/2026

🚨 NEW PODCAST ALERT 🚨

E/M leveling… simple, right? Or maybe not. 😅

In this episode, Scott, Mark, and special guest Dr. John Lin tackle real-world evaluation & management (E/M) scenarios submitted by members of the Thriving Urology Practice Facebook Group.

Using practical cases—BPH follow-ups, elevated PSA management, overactive bladder, recurrent UTIs, and constipation—they walk through how to apply medical decision-making rules to determine the correct level of service.

🔎 They cover:

Chronic stable conditions

Prescription drug management

Documentation pitfalls

Automatic downcoding

The gray areas that make E/M leveling “clear as mud”

💡 The big takeaway?
Understanding the rules is essential—but precise documentation is what ultimately gets you paid.

Listen now and sharpen your E/M strategy. 🎧
https://www.prsnetwork.com/278

Urologists and urology practice staff: Administrators, APPs, Billers and Coders Unite! Your co-hosts, Mark, Scott and Dr. Ray Painter are on a mission to help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life.

02/25/2026

Have you ever wondered how to ensure reimbursement for disposable flexible ureteroscopes in your op notes?

A surgery center recently asked providers to improve dictation language to capture code C9761. Learn how simple documentation tweaks—like stating "disposable flexible ureteroscope with suction/aspiration was used"—can secure proper reimbursement and support your ASC’s financial health.

🎙️ We cover this important tip at 40:07 in the latest episode of the Medical Coding & Billing Podcast!

📲 Listen now: https://www.prsnetwork.com/246

Urologists and urology practice staff: Administrators, APPs, Billers and Coders Unite! Your co-hosts, Mark, Scott and Dr. Ray Painter are on a mission to help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life.

02/23/2026

🚨 NEW PODCAST ALERT 🚨

The New Economics of In-Office Prostate Biopsies 🎙️

What’s changed with reimbursement?
How should your practice respond?

In Podcast 277, Scott, Mark & Dr. Ray Painter break down the numbers and what they mean for urology practices today.

If you’re a urologist, administrator, APP, biller, or coder — this episode is for you.

🎧 Listen now
Link in bio or visit: prsnetwork.com/277

Urologists and urology practice staff: Administrators, APPs, Billers and Coders Unite! Your co-hosts, Mark, Scott and Dr. Ray Painter are on a mission to help urologists and staff achieve peak economic and practice efficiency so there is time and energy to focus on patient care and a happy life.