tci Medicare Compliance & Reimbursement - 2023 Issue Q3

Part B Coding Coach: Urology: Boost Stent Placement Coding With This Primer

Plus: MAC found a 59% error rate for 52332 — find out why before it's too late Physicians may place a stent for a variety of reasons for urology patients. However, the documentation needs show the insurer the care was medically necessary — or you’ll be performing that procedure for free. Background: Part B Medicare Administrative Contractor (MAC) CGS Medicare reviewed 108 claims for urinary stent placement code 52332 (Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)). The payer found a startling 59.3 percent error rate among these claims, with the biggest denial...

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