American Urological Association - Coding and Reimbursement Committee

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Coding and Reimbursement Committee

A Standing Committee Reporting to the Public Policy Council
The AUA's Coding and Reimbursement Committee (CRC) consists of volunteer urologists representing expertise in different urologic subspecialties such as pediatric urology, calculus, laparoscopic procedures, incontinence, etc., as well as, all practice settings. Selected committee members represent the AUA before the American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Panel to request new and revised CPT codes to ensure accurate identification of services and procedures in the treatment of urologic diseases. CPT codes are used to report these services to public and private insurers on medical claims.

The mission of the CRC "serves as urology's representative in the area of coding, terminology development and reimbursement. They also seek new and updated codes to ensure accurate identification of urologic diseases and procedures."

The CRC will occasionally issue coding guidance on urologic procedures if requested. In addition, this guidance may include the necessity for a new CPT code to report the procedure/treatment/device in medical claims to third party insurers. The CRC follows the required criteria established by the AMA CPT Editorial Panel for new or revised CPT codes. Healthcare Common Procedure Coding System (HCPCS) for supplies, products and services that may be submitted to public and private insurers may also be reviewed. Learn more about the process for requesting coding guidance.

CRC members also review and present valuations for new or existing CPT codes through the AMA/Specialty Society Relative Value Scale Update Committee (RUC), in which both seasoned volunteer urologists and experienced AUA staff participate. The CRC also represents the AUA before the International Classification of Diseases (ICD) Coordination and Maintenance Committee to ensure proper diagnosis coding for urology. The CRC also meets occasionally with government entities to discuss issues of mutual concern affecting urologic care of our patients and issues affecting Medicare, Medicaid and other insurance carriers.

The CRC meets several times per year either in face-to-face meetings or by conference call. In addition, workgroups might be convened to address items of specific concern. The CRC also conducts business through electronic communications throughout the year.

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