Ray Painter, MD
Urologist Ray Painter, MD, is president of Physician Reimbursement Systems, Inc., in Denver, and is also publisher of Urology Coding and Reimbursement Sourcebook.
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Physician Quality Reporting System: There’s still time to avoid penalties in 2015
All eligible providers who do not participate in PQRS in 2013 will be subjected to a 1.5% penalty in 2015 and 2% penalty in 2016 and beyond. As you may be aware, there are many ways to participate in PQRS to avoid the 2015 penalty.
Non-physician providers: What urologists need to know about billing
The NPP is an intriguing asset to a urology group and, as with other assets, requires monitoring from the business, clinical, and billing aspects. This article will provide some guidance and interpretation for reporting service requirements under the Medicare program.
Preparing for ICD-10: Steps for urologists to take now, later
The amount of money that has been spent by payers and vendors with deep lobbying pockets has made the delay of ICD-10 implementation highly unlikely. As such, we are recommending that every practice assume that Oct. 1, 2014 is the implementation date.
Urologists should be prepared to justify ‘medical necessity’
The way medical necessity is currently being reviewed and judged is cause for concern.
How to bill for radiation treatment planning
We would recommend for best practices that the urologist reviewing treatment planning for CyberKnife include in the patient record a clear indication that the radiation oncologist’s treatment plan was reviewed in detail.
What changes to the –59 modifier mean for you
We’ve received a number of questions pertaining to the change in Medicare rules regarding the –59 modifier. Although in a previous column we discussed this change in relation to kidney stones specifically, we feel the interest generated by this change warrants a deeper dive into this subject.
How to get the most out of selling to a hospital
When negotiating with a hospital to purchase your practice, there are many questions that you should review in addition to the dollar per unit you are paid or measured against as an employed physician.
Private sector changes: Flashback to HMO days
As the health care landscape shifts to meet the needs of ACA, it's beginning to look a bit like it did in the heady days of HMOs.
How to bill for separate stones in the same kidney
Medicare recently made it clear that you should be able to charge for procedures performed on two separate lesions, which are not contiguous, in the same organ.

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