Urology Practices
Clean Claim Rate
Revenue Recovered
Claim Turnaround
A urology practice in Austin noticed a troubling pattern: their top surgeon’s RVU production was rising, but collections stayed flat. The problem traced back to systematic undercoding of office-based cystoscopy procedures and missed charge capture for urodynamic studies. Two revenue streams, invisible to the billing team, had been leaking for over a year.
We see this across urology practices regularly. The specialty blends high-volume office visits with complex surgical procedures, and most billing teams are strong at one but weak at the other. Our team covers both, from in-office cystoscopy and urodynamic billing to radical prostatectomy and kidney surgery coding.
Every Urology billing team deals with payer delays, coding nuance, and collection leakage. We tighten those weak points before they turn into write-offs.
Cystoscopy (52000), urodynamic studies (51726-51741), and prostate biopsies (55700) performed in-office are frequently underbilled because staff treat them as extensions of the E/M visit rather than separately billable procedures.
Urological surgeries range from outpatient cystoscopy with stent placement to robotic prostatectomy. Each procedure has specific coding rules, global period management, and modifier requirements.
Transrectal and MRI-fusion prostate biopsies involve the procedure code, imaging guidance, and pathology interpretation. Coordinating all three billing streams prevents duplicate charges and missed revenue.
ED treatments, testosterone replacement therapy, and male infertility services occupy a gray zone between medical and elective. Diagnosis coding and documentation must clearly establish medical necessity.
Support spans the full revenue cycle, from front-end verification to denial recovery and reporting.
In-office cystoscopy and procedure charge capture
Urodynamic study billing (CMG, EMG, pressure flow)
Robotic and laparoscopic urological surgery coding
Prostate biopsy and pathology billing coordination
Lithotripsy and kidney stone procedure billing
Prior authorization for advanced imaging and surgical procedures
We support independent practices, multisite groups, and growing provider organizations with flexible workflows.
Independent physician groups
Multi-location practices
Private equity backed platforms
Hospital-owned outpatient groups
A urology practice in Austin noticed a troubling pattern: their top surgeon’s RVU production was rising, but collections stayed flat. The problem traced back to systematic undercoding of office-based cystoscopy procedures and missed charge capture for urodynamic studies. Two revenue streams, invisible to the billing team, had been leaking for over a year.
We see this across urology practices regularly. The specialty blends high-volume office visits with complex surgical procedures, and most billing teams are strong at one but weak at the other. Our team covers both, from in-office cystoscopy and urodynamic billing to radical prostatectomy and kidney surgery coding.
Answers to the questions practice owners and managers ask most often before switching billing partners.
We audit procedure logs against billed claims to identify cystoscopies, urodynamic studies, and minor office procedures that were performed but not billed. For most practices, this audit uncovers $50,000 to $150,000 in annual unbilled revenue within the first 60 days.
Urodynamic studies involve multiple components: simple CMG (51726), complex CMG (51728), voiding pressure study (51729), EMG (51784-51785), and uroflow (51741). Each component is billed separately based on which tests were performed. We review the urodynamic report to ensure every component is captured.
Yes. Robotic-assisted laparoscopic prostatectomy (55866) includes specific documentation requirements for the robotic approach, and the global period restricts follow-up billing for 90 days. We manage the surgical billing, track the global period, and apply appropriate modifiers for complications or unrelated follow-up visits.
Kidney stone treatment billing depends on the approach: extracorporeal shock wave lithotripsy (50590), ureteroscopy with laser lithotripsy (52353), and percutaneous nephrolithotomy (50080-50081). We select the correct code based on stone location, approach, and technique documented in the operative report.
Common procedures requiring prior auth include cystoscopy with biopsy, robotic prostatectomy, lithotripsy, and advanced imaging (CT urogram, MRI prostate). We submit authorization requests with procedure-specific clinical documentation to minimize delays.
Yes. Vasectomy (55250) and vasectomy reversal (55400) have straightforward coding, but male fertility services like semen analysis (89320-89322) and sperm retrieval procedures require careful documentation of medical necessity. We ensure proper diagnosis coding to support insurance coverage when applicable.
The difference is operational discipline. We focus on clean submissions, fast follow-up, and transparency.
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