March 20, 2026

In this episode, Scott, Mark, and Dr. Ray Painter break down a new UnitedHealthcare policy that could impact payment for professional components of diagnostic services—including urodynamics and other PCTC-coded procedures—and what practices must document to avoid denials. The discussion outlines the need for clearly separated diagnostic reports with findings and impressions, as payers increase prepayment scrutiny. The key takeaway: as payer oversight intensifies, precise, structured documentation—and understanding how rules are applied—is essential to getting paid.

PRS Coding and Reimbursement Hub

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Botox LCD Alert

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Free In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)

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PRS Coding Courses

For Urologist

For APPs

For Coders, Billers, and Admins

Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

March 13, 2026

In this episode, Scott, Mark, and Dr. Ray Painter tackle three emerging reimbursement challenges affecting urology practices: widespread denials for testosterone pellet (Testopel®) therapy, the growing trend of secondary payers requiring prior authorization for high-cost drugs, and whether urology questionnaires qualify as billable health risk assessments.

PRS Coding and Reimbursement Hub

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Botox LCD Alert

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Free In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)

Download Now

PRS Coding Courses

For Urologist

For APPs

For Coders, Billers, and Admins

Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

March 6, 2026

In this episode, Scott, Mark, and Dr. Ray Painter break down the complex “alphabet soup” of Medicare coverage and auditing tools—including NCDs, LCDs, LCAs, RAC audits, and the emerging WISER program—and explain how they work together to shape reimbursement policy. Prompted by a new multi-state LCD affecting Botox coverage, the discussion walks through how coverage determinations are created, how Medicare contractors enforce them, and why documentation requirements continue to expand. The panel also explores how practices can adapt by building workflows, intake forms, and clinical documentation processes that capture the data Medicare expects—helping physicians navigate audits while still delivering appropriate patient care.

PRS Coding and Reimbursement Hub

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Botox LCD Alert

Download the Alert

Free In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)

Download Now

PRS Coding Courses

For Urologist

For APPs

For Coders, Billers, and Admins

Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

February 27, 2026

In this episode, Scott, Mark, and special guest Dr. John Lin tackle real-world evaluation and management (E/M) scenarios submitted by members of the Thriving Urology Practice Facebook Group. Through practical examples—including BPH follow-ups, elevated PSA management, overactive bladder, recurrent UTIs, and constipation—they break down how to apply medical decision-making rules to determine the correct level of service. The discussion highlights chronic stable conditions, prescription drug management, documentation pitfalls, automatic downcoding, and the ongoing gray areas that make E/M leveling “clear as mud.” The key takeaway: understanding the rules is essential—but precise documentation is what ultimately gets you paid.

PRS Coding and Reimbursement Hub

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Free In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)

Download Now

PRS Coding Courses

For Urologist

For APPs

For Coders, Billers, and Admins

Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

February 20, 2026

In this episode, Scott, Mark, and Dr. Ray Painter break down the financial realities of the new prostate biopsy CPT codes and what they mean for urology practices. Moving beyond coding mechanics, the discussion focuses on the economic differences between transrectal and transperineal approaches, MRI fusion versus ultrasound guidance, targeted lesion add-on payments, and the site-of-service differential between office and facility settings. They explore how practice expense values, capital equipment costs, disposable supplies, physician time, and block scheduling all factor into the decision to bring advanced biopsy techniques in-house. The episode emphasizes balancing clinical judgment with financial sustainability—helping practices evaluate whether expanding in-office prostate biopsy services makes sense now and in the future.

PRS Coding and Reimbursement Hub

Access the Hub

Free In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)

Download Now

PRS Coding Courses

For Urologist

For APPs

For Coders, Billers, and Admins

Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

February 13, 2026

In this special live episode recorded at the Urology Advanced Coding and Reimbursement Seminar in New Orleans on January 31st, 2026, Scott, Mark, Dr. John Lin, and Marianne DeSciose dive into one of the most contentious coding battles in urology: billing E/M services with cystoscopy on the same day. Prompted by a real-world question from the Thriving Urology Practice Facebook Group, the panel explores when modifier 25 is appropriate, why denials happen, and how to build documentation and appeal strategies that get results. With input from attendees, the episode brings practical insights from the front lines of coding, billing, and payer negotiations.

PRS Coding and Reimbursement Hub

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Free Kidney Stone Coding Calculator

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PRS Coding Courses

For Urologist

For APPs

For Coders, Billers, and Admins

Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

February 5, 2026

In this episode, Scott, Mark, and Dr. John Lin break down the latest telehealth news—Congress has officially extended Medicare telehealth coverage through the end of 2027, offering long-term stability for practices. They also answer a listener's question about billing 52235 and 51720 together, covering when a modifier can be used and how to document instillation in the recovery room properly. The episode wraps with a cautionary tale about “medically impossible days,” where excessive use of time-based coding and level 5 visits can trigger audits and serious compliance risk. Stay informed, stay compliant, and keep calm—telehealth on.

PRS Coding and Reimbursement Hub

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Free Kidney Stone Coding Calculator

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PRS Coding Courses

For Urologist

For APPs

For Coders, Billers, and Admins

PRS Billing and Other Services - Book a Call with Mark Painter or
Marianne Desciose

Click Here to Get More Information and Request a Quote

Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

January 30, 2026

On this episode, Scott and Mark Painter sit down with Dr. Sida Niu and Tyler Hamik, co-founders of docology, an AI-driven clinical intake and workflow automation platform. Dr. Niu explains how docology was born out of his own frustration with after-hours chart review, and how the tool now distills massive referral packets into clear, focused summaries—saving hours of prep time. Tyler shares how docology integrates with EMRs to automate front-end document intake and insurance data capture, dramatically reducing administrative overhead. They also discuss their recent selection to the AUA Innovation Nexus and invite physicians to help shape the future of the platform.

Get in touch with docology:

https://docologyhealth.ai

Tyler Hamik

PRS Coding and Reimbursement Hub

Access the Hub

Free Kidney Stone Coding Calculator

Download Now

PRS Coding Courses

For Urologist

For APPs

For Coders, Billers, and Admins

PRS Billing and Other Services - Book a Call with Mark Painter or
Marianne Desciose

Click Here to Get More Information and Request a Quote

Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/