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Artwork for Urology Coding and Reimbursement Podcast

Urology Coding and Reimbursement Podcast

Mark Painter, Scott Painter and Dr. Ray Painter
Urology
Medicare
Telehealth
Modmed
Revenue Cycle Management
Medicare Advantage
Government Shutdown
G2211
Cystoscopy
Incident Two Billing
Urology Coding
Downcoding
Urology Practices
Medicaid
Reimbursement
Documentation
2025 CMS Final Rule
C9761
CPT Coding
CPT Codes

The Urology Coding and Reimbursement Podcast is for Urologists and urology practice staff: Administrators, APPs, Billers and Coders. We 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. Your cohosts, Mark, Scott and Dr. Ray Painter discuss urology coding and share best practices for the urology office. We ... more

PublishesWeeklyEpisodes296Founded6 years ago
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Health & Fitness

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Artwork for Urology Coding and Reimbursement Podcast

Latest Episodes

July 24, 2026

In this episode, Scott, Mark, and Dr. Ray Painter examine a major shift in Medicare’s approach to coding UTI PCR testing. The discussion explains why reimbursement may now depend on the number of testing kits, methodologies, or procedu... more

July 17, 2026

In this episode, Scott and Mark Painter provide their initial analysis of CMS's proposed 2027 Medicare Physician Fee Schedule and highlight the changes most likely to impact urology practices. The discussion covers the proposed convers... more

July 10, 2026

In this episode, Scott, Mark, and Dr. Ray Painter break down CMS’s latest updates to facility reimbursement for kidney stone procedures, including the revised C9761 code, the new C8014 code, and the payment implications for hospitals a... more

June 26, 2026

In this episode, Scott, Mark, and Dr. Ray Painter continue their discussion on buy-and-bill drugs, using ZUSDURI® as a case study to explore the clinical, operational, and reimbursement challenges facing urology practices. The conversa... more

June 19, 2026

In this episode, Scott, Mark, and Dr. Ray Painter tackle three challenging reimbursement scenarios submitted by listeners: Medicare denials for category III code 0816T, handling patient payments when claims are denied for timely filing... more

June 12, 2026

In this episode, Scott, Mark, Dr. Ray Painter, and special guest Marianne DeSciose discuss the growing wave of payer scrutiny impacting urology practices, including automatic E/M downcoding, stealth denials, medical record requests, ta... more

June 5, 2026

In this episode, Scott, Mark, and Dr. Ray Painter provide an important update on the evolving C9761 reimbursement landscape, including CMS’s decision to revise the code description and introduce a new HCPCS code for suction-enabled uret... more

May 22, 2026

In this episode, Scott, Mark, and Dr. Ray Painter revisit ureteral stent removal and replacement coding after listener feedback highlighted the need for additional clarification on when cystoscopic codes versus fluoroscopic exchange cod... more

Key Facts

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Recent Guests

Bill Brudson
Urology practitioner discussed as a case study guest
Urology
Episode: UCR 294: Buy-and-Bill Drugs in Urology – Protecting Your Practice from Costly Mistakes
Tyler Hamik
Co-founder, Chief Revenue Officer at Docology Health
Docology Health
Episode: UCR 274: Reducing Physician Burnout with AI – The docology Story
Sida Niu
Co-founder and Chief Medical Officer at Docology Health
Docology Health
Episode: UCR 274: Reducing Physician Burnout with AI – The docology Story
Ken Mitchell
A nationally recognized expert in men's health and sexual dysfunction with nearly 30 years of clinical experience.
Pizona MD
Episode: UCR 264: The Future of Urology: Addressing Workforce Challenges and APP Utilization with Ken Mitchell, PA-C
John Lin
Solo practitioner in Gilbert, Arizona and founder of the Thriving Urology Practice Facebook group.
Thriving Urology Practice
Episode: UCR 257: Clearing the Field — Catheters That Suck and Understanding C9761
Dr. Marc Rose
Practicing urologist in Vero Beach, Florida, with a hybrid urology practice combining insurance and concierge models.
Rose Urology
Episode: UCR 256: A Hybrid Urology Practice—Dr. Marc Rose’s Concierge Model Journey
Dr. Peter Bretan
President of the American Association of Clinical Urologists, former president of the California Medical Association
American Association of Clinical Urologists
Episode: UCR 250: Advocacy, Policy, and the Future of Urology with Dr. Peter Bretan
Marianne Descoise
COO of PRS Managed Services
PRS Managed Services
Episode: UCR 229: Takeaways from the Urology Advanced Coding and Reimbursement Seminar in New Orleans
Marianne Desois
COO of PRS Managed Services
PRS Managed Services
Episode: UCR 227: Understanding Recoupments – How to Protect Your Practice’s Revenue

Hosts

Scott Painter
Host of the podcast; primary speaker with recurring role across episodes.
Mark Painter
Co-host and recurring panelist; contributes coding and reimbursement expertise.
Dr. Ray Painter
Co-host; physician presenter and clinician contributor.

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Talking Points

Recent interactions between the hosts and their guests.

UCR 294: Buy-and-Bill Drugs in Urology – Protecting Your Practice from Costly Mistakes
Q: How should practices approach prior authorizations and emerging AI tools?
Maintain strong policies, train staff, and monitor AI-assisted processes; use AI as a time saver but continue to supervise to prevent misclassifications and ensure compliance.
UCR 294: Buy-and-Bill Drugs in Urology – Protecting Your Practice from Costly Mistakes
Q: What is the core financial risk when drugs have low margins if they aren't fully collected?
The core risk is operating at a loss due to the variable cost of drugs, so practices must ensure almost all drug charges are collected and that documentation supports the reimbursement.
UCR 293: Unprocessable Claims, Timely Filing Denials, and Urodynamics Global Billing
Q: Should we switch to a new CPT code right away when a claim is unprocessable, especially with a category 3 code like 0816T?
No. The code 0816T is a valid CPT code; first confirm denial reasons, review the full claim, LCAs, and payer-specific rules before changing codes or submitting a new claim.
UCR 291: C9761 Update, Intraoperative Consults, and Office-Based Procedure Challenges
Q: Can interoperative consultations be billed when the patient is under general anesthesia?
It depends on the circumstances: if the physician is called to the operating room to provide an opinion at another physician's request and documents a history, limited physical exam, medical decision-making, and a plan, then it can be billed as an E&M code; if the call is for a procedural repair without a consultation, it would be a pure procedure rather than E&M.
UCR 287: Stent Removal & Replacement Codes and Bladder Cancer Maintenance ICD-10 Codes
Q: What should be done when a denial occurs during BCG maintenance therapy treatment, and how should ICD-10 codes be used?
For active bladder cancer treatment you should use bladder cancer codes (C67x family) and avoid unspecific codes like C679; for maintenance, use Z85.51 to indicate personal history if payer accepts it, but some payers require C67x initially due to denial patterns; in such cases, appeal with documentation first, and consider using C67x in the first position if persistent denial occurs, while adding Z codes later to reflect ongoing history; payer-specific rules vary and may necessitate navigation coding rather than strict ICD-10 coding.

Audience Metrics

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Frequently Asked Questions About Urology Coding and Reimbursement Podcast

What is Urology Coding and Reimbursement Podcast about and what kind of topics does it cover?

This show targets urology professionals and practice staff, with a focus on coding, reimbursement, and revenue cycle management for urology practices. Across episodes, the hosts—primarily Scott Painter, Mark Painter, and Dr. Ray Painter—dissect real-world coding challenges, payer policies, and the financial implications of adopting new technologies or procedures. Guests from the RCM and practice-management spaces frequently join to share playbooks, case studies, and practical steps to improve front-end readiness, documentation, and post-pay accountability. Notable throughlines include the interplay between coding rules, payer denials, and marketplace dynamics, as well as sponsor-supported segments highlighting practice-management tech (nota... more

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2. AUAUniversity
3. BackTable Urology
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5. White Coat Investor Podcast

How many episodes of Urology Coding and Reimbursement Podcast are there?

Urology Coding and Reimbursement Podcast launched 6 years ago and published 296 episodes to date. You can find more information about this podcast including rankings, audience demographics and engagement in our podcast database.

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What guests have appeared on Urology Coding and Reimbursement Podcast?

Recent guests on Urology Coding and Reimbursement Podcast include:

1. Bill Brudson
2. Tyler Hamik
3. Sida Niu
4. Ken Mitchell
5. John Lin
6. Dr. Marc Rose
7. Dr. Peter Bretan
8. Marianne Descoise

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