Urology Billing Services
Keep your practice focused on patient care - we’ll make sure you get paid for it. Long-term disease management, equipment use, and procedural severity combine in Urology. From cystoscopies and lithotripsy to prostate treatment, urodynamics, and complicated reconstructive surgery, correct billing requires expert expertise, thorough documentation, and payer-by-payer dexterity - that's from Sirius Solutions. Globally, we declutter the administrative chaos so that urologists, hospitals, and clinics may focus on patients, and your income cycle is humming along.
Our Comprehensive Urology Billing Services
We tailor our services to the way your practice works whether you’re a solo urologist, a multi-provider group, an ASC, or a hospital department.
1. Specialty Coding & Chart Review
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Precise CPT, ICD-10, and HCPCS coding for outpatient procedures, cystoscopy, TURP, ureteroscopy, lithotripsy, prostate operations, reconstructive urology, and female pelvic medicine.
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Modifier management (e.g., RT/LT, 59, 76/77, 26/TC) to protect reimbursement.
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Post-op and global period management to prevent double-billing or missed revenue.
2. Procedure & OR Charge Capture
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End-to-end charge mapping for OR supplies, implants, and device serial tracking when payers require it.
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Coordination with supply chain and OR staff so nothing billable is left behind.
3. Prior Authorization & Benefits Verification
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Previsit verification and prior authorizations for implants, specialist treatments, sophisticated imaging, and expensive pharmaceuticals.
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Transparent patient financial estimates to reduce surprise balances.
4. Claims Submission & Payer-Specific Scrubbing
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Clean claims with payer rules, LCDs/NCDs, and local edits applied to maximize first-pass acceptance.
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Fast electronic submission and systematic follow-up on pended claims.
5. Denial Management & Appeals
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Root cause analysis, appropriate coding or documentation repairs, and relentless appeals for high-dollar claims.
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Trend reporting to eliminate repeat denials at the source.
6. DME & Supply Billing
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Proper handling of catheter supplies, intermittent catheter codes, external appliances, and prosthetics where applicable.
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Proof-of-delivery tracking and supplier coordination.
7. Drug & Infusion Billing
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Billing for physician-administered medications (e.g., intravesical treatments) with precise J code units and administration paperwork.
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Coordination for buy-and-bill or specialty pharmacy processes as necessary.
8. Account Receivable (A/R) Management
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Aging buckets given top priority for recovery include targeted follow-up on unpaid and underpaid claims.
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Contract validation and underpayment recovery workflows.
9. Compliance & Audit Readiness
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Documentation templates and chart audits designed to withstand payer reviews and audits.
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HIPAA-compliant processes and secure record handling.
10. Reporting & Business Intelligence
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Actionable KPI dashboards include denial rate by reason, days in A/R, payer performance, case-level profitability, and implant reimbursement variance.
Typical outcomes clients see
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Higher first-pass acceptance rates — fewer pended or denied claims.
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Shorter days in A/R — quicker collections and less follow-up.
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Recovered revenue through targeted appeals and underpayment audits.
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Lower denial rates for procedural and device claims.
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Operational relief — staff spend less time on billing fires and more on patient care.
Why urology billing is different
Urology billing mixes standard office care with procedure-heavy, device-dependent services. Common challenges include:
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Procedural complexity: Specific coding rules and global periods apply to endoscopic procedures, cystoscopy with biopsy, TURP, ureteroscopy, lithotripsy, vascular device implants, and robotic prostatectomies, hence increasing procedural complexity.
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Multiple payers & benefits: Each of Medicare, Medicaid, worker's compensation, commercial policies, and VA/Tricare approaches treatments, DME, and medications differently; therefore, there are many payers and advantages.
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Device & supply billing: Stents, catheters, implants, and disposables sometimes have distinct HCPCS/L codes and evidence-of-delivery demands.
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Time-based services and critical care: Postop critical care, time-based urodynamics, and observation services call for precise time capture and documentation among time-based services and critical care.
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Bundling and modifier use: When is image guidance charged? When is the biopsy combined with the major operation? Modifiers (RT/LT, 59, 26/TC, etc.) need to be accurate.
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High audit risk for high-cost items: Implants, complex equipment, and expensive pharmaceuticals arouse curiosity; documentation has to be perfect.
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Frequent prior authorizations: Necessary for a lot of sophisticated surgeries, injectable pharmaceuticals, and implanted equipment to prevent denied claims.
Left unchecked, these issues lead to denials, write-offs, and frustrated staff. A urology-savvy billing partner prevents revenue leakage and reduces administrative friction.
Real-world scenarios we handle every day
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Cystoscopy with biopsy: ensure pathology and biopsy add-on codes are captured and linked to the correct diagnosis.
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Ureteroscopy & lithotripsy: correct units, use of image guidance, stent placement, and removal charges.
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Robotic prostatectomy: separate professional fees, device disposables, and surgeon time captured properly.
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Urodynamics & pelvic floor testing: timed services, facility vs professional components, and interpretation codes.
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Catheter and DME supplies: appropriate HCPCS codes, proof-of-delivery, and frequency checks.
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Oncology-related urology procedures: coordination between surgical, medical oncology, and radiation billing streams.
How we practically improve collections
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Cystoscopy with biopsy: ensure pathology and biopsy add-on codes are captured and linked to the correct diagnosis.
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Ureteroscopy & lithotripsy: correct units, use of image guidance, stent placement, and removal charges.
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Robotic prostatectomy: separate professional fees, device disposables, and surgeon time captured properly.
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Urodynamics & pelvic floor testing: timed services, facility vs professional components, and interpretation codes.
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Catheter and DME supplies: appropriate HCPCS codes, proof-of-delivery, and frequency checks.
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Oncology-related urology procedures: coordination between surgical, medical oncology, and radiation billing streams.
AI-Driven Urology Billing: Smarter Technology with a Human Touch
With AI, we’re able to:
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Predict denials before they happen by identifying coding or documentation gaps.
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Automate repetitive tasks like charge entry, eligibility checks, and claim tracking.
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Spot revenue leakages instantly using real-time data analytics.
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Provide actionable insights to improve reimbursement rates and practice growth.
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