October 31, 2025 In this Halloween-themed episode, Scott, Mark, Ray, and special guest Dr. John Lin explore the “curse” of poor documentation and its real-world consequences, including payer audits, downcoding, and revenue loss. They discuss how vague or incomplete documentation—even when care is appropriate—can lead to denials and clawbacks, especially in today’s AI-assisted claims review environment. The team also covers practical strategies to improve documentation, the risks of ov...
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October 31, 2025 In this Halloween-themed episode, Scott, Mark, Ray, and special guest Dr. John Lin explore the “curse” of poor documentation and its real-world consequences, including payer audits, downcoding, and revenue loss. They discuss how vague or incomplete documentation—even when care is appropriate—can lead to denials and clawbacks, especially in today’s AI-assisted claims review environment. The team also covers practical strategies to improve documentation, the risks of ov...
UCR 247: 2 New Denial Twists - 1) getting E/M, G2211, and UA paid; 2) downcoding; and revisiting coding for graft around the urethral anastomosis during prostatectomy (from Episode #234)
Urology Coding and Reimbursement Podcast
30 minutes
5 months ago
UCR 247: 2 New Denial Twists - 1) getting E/M, G2211, and UA paid; 2) downcoding; and revisiting coding for graft around the urethral anastomosis during prostatectomy (from Episode #234)
June 13, 2025 In this episode, Ray, Mark, and Scott discuss recent denial issues from Aetna and Humana and offer some possible solutions. They also revisit a question covered in Episode #234: billing for amniotic tissue grafts during prostatectomy procedures, outlining strategies to address denials effectively. PRS Coding and Reimbursement Hub Access the Hub Jelmyto Coding and Reimbursement Page Upper Track Urothelial Cancer (UTUC) Coding and Reimbursement Page Free Kidney Stone Co...
Urology Coding and Reimbursement Podcast
October 31, 2025 In this Halloween-themed episode, Scott, Mark, Ray, and special guest Dr. John Lin explore the “curse” of poor documentation and its real-world consequences, including payer audits, downcoding, and revenue loss. They discuss how vague or incomplete documentation—even when care is appropriate—can lead to denials and clawbacks, especially in today’s AI-assisted claims review environment. The team also covers practical strategies to improve documentation, the risks of ov...
