AMA Moves Urology Category III CPT Codes to October 1, 2026
QUICK ANSWER What the AMA Changed on August 7 On August 7, 2026, the AMA updated its Category III code documents to reflect an action taken by the CPT Editorial
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Explore advice and insights to transform urology medical billing, enhancing efficiency and profitability.
N20.0 Calculus of Kidney: The 2026 ICD-10 Coding and Billing Guide for Urology
QUICK ANSWER N20.0 vs. the Rest of the N20 Family: Get the Stone Location Right The single most common N20.0 error is using it for a stone that is not
CMS Proposes 50% Payment Cut on Same-Day Urology E/M Visits Billed With Modifier 25
QUICK ANSWER What CMS Proposed on July 14 CMS released the CY 2027 Physician Fee Schedule proposed rule (CMS-1848-P) on July 14, 2026. Among the dozens of provisions in the
CPT Code 52005 in 2026: Global Days, Bilateral Billing, and Modifier 50
QUICK ANSWER Are There Pre-op Days for CPT 52005? No. CPT 52005 carries a 000-day global period, which makes it a minor procedure under Medicare payment rules. The global value
Medicare WISeR Model: What Urology Practices in 6 States Need to Know About Prior Authorization
QUICK ANSWER Why Medicare Now Requires Prior Auth for Urology Procedures Prior authorization has been a standard tool in Medicare Advantage for years, but traditional fee-for-service Medicare largely avoided it.
CPT Code 55700 in 2026: Why It Was Deleted and What Replaced It
QUICK ANSWER What Was the CPT 55700 Code Description? CPT 55700 described a prostate biopsy by needle or punch, single or multiple specimens, performed through any approach. It was reported
CMS Proposes 55% Payment Increase for Prostatic Stent and Major Urology ASC Expansion in 2027
QUICK ANSWER What CMS Proposed on July 2 CMS released the CY 2027 OPPS/ASC proposed rule (CMS-1850-P) on July 2, 2026. For urology practices, three provisions stand out. The CPT
CPT 51798: Description, Modifiers, and Medicare Reimbursement for the Bladder Scan
QUICK ANSWER What Does CPT 51798 Cover? CPT 51798 reports a post-void residual (PVR) measurement taken with a handheld, non-imaging ultrasound bladder scanner. The device is placed over the suprapubic
Urology Reimbursement in 2027: Why CMS Projects a 2% Cut and How to Prepare
QUICK ANSWER What CMS Proposed for Urology On July 14, 2026, CMS published the CY 2027 Medicare Physician Fee Schedule proposed rule (CMS-1848-P). The American Urological Association published an initial
Modifier 50: Bilateral Procedure Billing, Reimbursement and Rules for 2026
QUICK ANSWER What Modifier 50 Covers Modifier 50 applies when a surgeon performs the same procedure on both sides of a paired anatomical structure during a single operative session. The
