The information on this page provides resources for reimbursement of urologic treatments.

Understanding the Reimbursement Process

• Physician Reimbursement: Path to Payment [pdf]
• Physician Fee Schedule

National Provider Identifier Application

Don't Forget Your NPI. National Provider Identifier (NPI) compliance will go into effect in May 2007, and the Centers for Medicare & Medicaid Services are encouraging all physicians to apply sooner rather than later. The NPI is free and can be applied for online.

Sample Forms

• Consultation Verification Form [pdf]
• Consultation Versus Transfer of Care Flowchart [pdf]
• Transrectal Prostate Ultrasound and Prostate Biopsy Report [pdf]
• Smoking Cessation Worksheet [pdf]

Common Urology Drug Payment

• What is the Average Sales Price (ASP) for Drugs and How does CMS Calculate the ASP Based Payment Limit? [pdf]
• Quarterly ASP Drug Payments Chart [pdf]

Medical Coding

Current Procedural Terminology (CPT)

• New CPT handout [pdf]

International Classification of Diseases Diagnosis Coding

• ICD-9-CM
• ICD-10-CM

Resources

• Coding Resources

Coverage Policies

• Botox [xls]
• Coverage for Administration Codes – Part B Drugs [xls]
• MAC/Carrier XIAFLEX Coverage [xls]
• PTNS Coverage [xls]
• Urolift [xls]