PRSnetwork

PRSnetwork Committed to Improving the Practice of Medicine

Since 1989, PRS has been providing up-to-the-minute, precise medical coding information and error-free claims processing instruction maximizing physician reimbursement dollars. Today our expanding network of tools and services are designed around the unique needs of specific medical specialties. This specialized approach makes it easier for physicians to eliminate costly billing errors and improve overall practice efficiency and cash flow.

❓ Coding Question Spotlight from Episode 184 (12:34)"Does CPT 52281 apply when a cystoscope is passed to dilate a urethr...
04/08/2026

❓ Coding Question Spotlight from Episode 184 (12:34)
"Does CPT 52281 apply when a cystoscope is passed to dilate a urethral or meatal narrowing, or is it reserved only for procedures involving an actual incision (like meatotomy or DVIU)?"
🎧 Tune in to our latest podcast episode to hear the full discussion and clarify when it's appropriate to use 52281. https://www.prsnetwork.com/184

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.

🔍 Coding Clarity Alert!Can you bill 52001 for cysto and clot evacuation when using a syringe under local anesthesia? Or ...
04/06/2026

🔍 Coding Clarity Alert!
Can you bill 52001 for cysto and clot evacuation when using a syringe under local anesthesia? Or is it more appropriate to use 52000 + 51700? 🤔
We broke it down in Episode 184 at 10:06 of the PRS Podcast!
🎧 Tune in to avoid miscoding and ensure accurate reimbursement.
https://www.prsnetwork.com/184

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.

💡 Split/Shared Visits & Real-Time DocumentationIn Episode 184 (3:23), we address a key Medicare compliance question: Doe...
04/03/2026

💡 Split/Shared Visits & Real-Time Documentation
In Episode 184 (3:23), we address a key Medicare compliance question: Does a physician need to document their portion of the MDM during the APP’s visit to bill under their NPI? The answer may surprise you! Tune in to learn why real-time involvement matters and how to protect your practice’s billing integrity.
🎧 Listen now: https://www.prsnetwork.com/184

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.

👨‍⚕️👩‍⚕️ Billing Alert for Hospitals!Can physicians bill for procedures performed by PAs in the hospital setting? 🤔This ...
04/01/2026

👨‍⚕️👩‍⚕️ Billing Alert for Hospitals!
Can physicians bill for procedures performed by PAs in the hospital setting? 🤔
This came up on Episode 182 at 3:18 — and it’s a key compliance point you’ll want to understand.
🎙️ Listen in for the full breakdown and stay compliant! https://prsnetwork.com/182

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.

🎧 Listen now: https://www.prsnetwork.com/282🎙️ Podcast 282: Playing the Surgical Lottery – Medicare Advantage and Out-of...
03/31/2026

🎧 Listen now: https://www.prsnetwork.com/282

🎙️ Podcast 282: Playing the Surgical Lottery – Medicare Advantage and Out-of-Network Strategy
📅 March 27, 2026

In this episode, Scott, Mark, and Dr. John Lin unpack the realities of working with Medicare Advantage (Part C) plans. From out-of-network challenges to unpredictable reimbursement—what they call a “surgical lottery”—they explore how providers can navigate an increasingly complex landscape.

Prompted by a real-world case involving UnitedHealthcare narrowing its network, the discussion covers:
• Out-of-network billing strategies
• Patient financial responsibility
• Contract pitfalls and risks
• The uncertainty of payment outcomes

💡 Bottom line: Know your numbers. Know your leverage. Be intentional about the payers you work with.

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.

👩‍⚕️👨‍⚕️ Billing via Supervisory Role – What’s Allowed?Can a physician bill if they only supervise and discuss the case ...
03/30/2026

👩‍⚕️👨‍⚕️ Billing via Supervisory Role – What’s Allowed?
Can a physician bill if they only supervise and discuss the case with a PA without seeing the patient in person? 🤔
We break it down in Episode 182 (3:18) of the PRS Network podcast!
🎧 Tune in to learn the compliance rules and how to avoid billing pitfalls. https://www.prsnetwork.com/182

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.

👨‍⚕️💬 Billing clarity matters! On Episode 182 of the PRS Network Podcast (3:18), we answered the important question: “Ar...
03/27/2026

👨‍⚕️💬 Billing clarity matters! On Episode 182 of the PRS Network Podcast (3:18), we answered the important question: “Are our physicians able to bill for those visits at 100%?”
✅ Listen in to make sure your practice is getting reimbursed correctly! https://www.prsnetwork.com/182

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.

👩‍⚕️ Can a Gyn-Urologist bill 99459 for pelvic exams performed during patient visits?In Episode 181 (19:48), we tackle a...
03/25/2026

👩‍⚕️ Can a Gyn-Urologist bill 99459 for pelvic exams performed during patient visits?

In Episode 181 (19:48), we tackle a common billing question: If a Gyn-Urologist routinely performs pelvic exams unsupervised, can 99459 still be added?

💡 The answer depends on documentation, medical necessity, and adherence to CPT guidelines. Tune in to get clarity and ensure compliant coding!

🎧 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.

🔍 Modifier -25 Confusion? We’ve Got Answers!If a patient returns for a routine SPT change or Lupron injection and the pr...
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.

🎙️ New Episode: Urology Coding and Reimbursement PodcastA new UnitedHealthcare documentation rule could impact how pract...
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.

🎙️ New Episode: Urology Coding and Reimbursement PodcastAre testosterone pellet therapies being denied more often? Are s...
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.

💡 Coding Clarification Alert!A PRS Network client recently asked about the correct CPT code for a robotic ureteroneocyst...
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.

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PRS helps physicians and their staff maximize reimbursement and compensation.