Urology Claims Audit
Cystoscopy bundling, urodynamic components, stone procedures, and office procedure capture reviewed together.
Urology bills across four settings from the same practice: office procedures alongside visits, component-based diagnostic testing, endoscopic work with dense bundling rules, and major surgery with global periods. Errors in each are different, and a general audit finds none of them well.
ZechionMed's urology claims audit reviews cystoscopy bundling, urodynamic component billing, stone management coding, surgical claims and global periods, and office procedure capture.
The largest recurring finding is usually the simplest: procedures performed in the office and billed only as a visit. It produces no denial, appears in no report, and repeats at every clinic session.
What We Cover
What We Audit
Cystoscopy Procedures
High-volume endoscopic work where bundling rules decide what is separately billable.
- Diagnostic versus therapeutic cystoscopy
- Bundled component identification
- Biopsy and fulguration coding
- Stent placement and removal
- Dilation and injection procedures
- Modifier 59 and X-series justification
Urodynamic Testing
Component-based testing where the components are billed individually and the necessity is scrutinised.
- Complex cystometrogram review
- Uroflowmetry coding
- Pressure-flow study coding
- Electromyography component
- Testing component separation
- Medical necessity documentation
- Equipment and supply billing
Kidney Stone Procedures
Multi-stage treatment where each stage needs coding on its own terms.
- Lithotripsy coding
- Ureteroscopy with stone extraction
- Stent placement and exchange
- Staged procedure modifiers
- Bilateral procedure billing
- Imaging guidance where separately payable
Urology Surgery
The highest-value claims, validated against the operative report.
- Surgical CPT accuracy
- Robotic and laparoscopic approach coding
- Multiple procedure sequencing
- Assistant surgeon billing
- Global period application
- Post-operative visit billing
- Operative report support for every code
Office Procedure Capture
The most common and least visible loss in the specialty.
- Office procedures identified from the note
- Same-day E/M and procedure billing
- Modifier 25 support
- Supply and drug billing where payable
- Missed procedure charge identification
Where Urology Claims Lose Value
Office procedures billed as visits
A procedure performed during an office visit is separately billable with the right documentation and modifier. Capturing only the E/M produces no denial and recurs every session.
Cystoscopy bundling
Components performed during a cystoscopy are sometimes bundled and sometimes separately payable. Erring either way costs — denials one direction, unbilled revenue the other.
Urodynamic components
Urodynamic studies are billed as components. Missing components under-claims; billing components that were not performed is exposure.
Global period write-offs
Post-operative visits, staged procedures, and returns to theatre inside a global period are billable with the right modifier and are routinely surrendered.
Staged stone treatment
Multi-stage stone management requires staged procedure modifiers. Without them the later stages read as duplicates rather than as planned continuation.
Frequently Asked Questions
Office procedures billed as visit-only. It is high-frequency, produces no denial, and appears in no report, which is exactly why it persists.
Contact ZechionMed
Capture the Procedure, Not Just the Visit
Cystoscopy bundling, urodynamic components, staged stone treatment, and office capture reviewed together.
Talk to ZechionMed about a urology claims audit.