Comparative Cost Analysis: Teleurology vs Conventional Face-to-Face Clinics.

OBJECTIVE: To compare costs associated with teleurology vs face-to-face clinic visits for initial outpatient hematuria evaluation. MATERIALS AND METHODS: The analysis included 3 cost domains: transportation, clinic operations, and patient time. Transportation cost was based on standard government travel reimbursement. Clinic staff cost was based on hourly salary plus fringe benefits. For a face-to-face clinic encounter, patient time included time spent for travel, parking, walking to and from clinic, checking in and checking out, nursing evaluation, urologic evaluation, laboratory, and waiting. Patient time cost was based on the Federal minimum wage. Provider and laboratory times were excluded from the cost analysis as these were similar for both encounters. RESULTS: We included 400 hematuria evaluations: 300 teleurology and 100 face-to-face. Both groups had similar median age (63 vs 64 years, P = .48) and median travel distance/time (58 vs 54 miles, P = .19; 94 vs 82 minutes, P = .09, respectively). Average patient time was greater for face-to-face encounters (266 vs 70 minutes teleurology, P < .001). Transportation was the primary driver of overall costs ($83.47 per encounter), followed by patient time ($32.87/encounter) and clinic staff cost ($18.68/encounter). The average cost per encounter was $135.02 for face-to-face clinic vs $10.95 for teleurology (P < .001) exclusive of provider and laboratory times. Cost savings associated with each telehematuria encounter totaled $124.07. CONCLUSION: Teleurology offers considerable cost savings of $124 per encounter for the initial evaluation of hematuria compared to face-to-face clinic. With 1.5 million annual hematuria encounters nationally, implementation of teleurology for hematuria evaluation offers cost savings approaching $200 million per year.

Is There an Appropriate Use of 76856/76857 in Urological Practice?

INTRODUCTION: Ultrasound and other diagnostic services have been under increasing scrutiny by payer organizations due to suspected overuse for monetary gain. For the urology practice ultrasound has grown in utility for diagnosis and treatment. METHODS: Articles and coding resources were reviewed in this discussion of the appropriate use of ultrasound codes. RESULTS: With increasing financial pressure from all fronts to regulate the appropriate use of technology in the treatment of patients and the targeted elimination of unnecessary tests, urology practices will be required to practice diligence in prescribing, providing and reporting all tests. Understanding ultrasound codes and their appropriate use requires an understanding not only of the codes themselves but also the alternative codes available for reporting. CONCLUSIONS: This article provides an overview of the CPT® coding options relative to ultrasound use in the urology practice.