August 7, 2026

In this episode, Scott, Mark, and Dr. Ray Painter answer three reimbursement questions involving common—but increasingly scrutinized—coding situations. First, they discuss when a urologist can separately bill the professional component of a radiologic service such as retrograde urography on the same day as an E/M service, including the documentation requirements and potential conflict when radiology also bills for the interpretation. Next, they examine a ureteroscopy denial caused by an inconsistent diagnosis code and explain how to properly distinguish kidney and ureteral stones with and without hydronephrosis. Finally, they tackle another modifier 25 denial and explain why simply citing NCCI rules in an appeal may not be enough—the documentation must clearly demonstrate the significant, separately identifiable E/M service that supports the modifier.

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