- +1 (773) 985-1869
- info@stream-rcm.com
- 14430 Ocean Point, El Paso, TX 79938
Did you know that almost 30% of all urology claims get rejected because of coding complexities? This is your income that is not processed. Stream RCM understands the peculiarities of billing for urology services, including the difficult modifiers 25 and 59. Instead of fixing your denials, we are preventing them. Partner with us to get rid of the “denial cycle” and decrease your DSO. Our urology billing company gives you an opportunity to concentrate on your patients.
Stream RCM handles urology procedures from diagnostic cystoscopy to bladder surgery. We have a thorough understanding of your codes, services, and carriers. Our team undergoes continuous training on the latest CPT changes, Medicare guidelines, and private payer policies. Our HIPAA-secure system includes encryption, security, and full auditability.
The result? Faster payments, fewer denials, and total peace of mind. You focus on patients. We focus on revenue.
Key Performance
Average A/R Days
< 25 days
Industry average: 38–45 days
Denial Rate
2.4%
62% below industry baseline
Net Collection Rate
97.8%
Top quartile performance
Client Revenue Growth
+22%
Average increase in first year
“They caught denials before they happened. Our revenue jumped 22%.”
— Dr. M. Reynolds, MD, FACS
We have experience in the entire range of urologic surgeries. We provide accurate coding and billing services for every subspecialty to ensure your practice earns more revenue.
We monitor the sequence of cystoscopy, biopsies, and resections for bladder cancer surveillance, using the right fulguration and tumor destruction codes to make sure that each recurring visit bills properly.
We deal with the intricate coding involved with the treatment of bladder and kidney cancers, including chemotherapy and cystoscopic surveillance to make sure faster payment.
We code incontinence procedures, urodynamic tests, and pelvic floor treatments with appropriate modifiers and diagnoses, eliminating any possible documentation errors that may cause delays in payment in female urology cases.
In the case of stone disease billing, several procedures occur within a single session; we properly code ureteroscopy, lithotripsy, and stent insertion so that bundled and staged procedures receive their proper reimbursement.
Vasectomies, reversals, and andrology codes are coded in light of current payer coverage policy and have advance warnings of those services which require a non-coverage warning.
You perform the urological procedures and patient care, and we will take care of all the rest, including coding, claims, denial, follow-up, and collections.
We check for insurance eligibility, copays, and deductibles prior to your patient’s appointment so that you will not be faced with any surprises after billing.
Our team checks every claim is filed properly on the first try, allowing for faster payment and decreased rejections. Your claim is accurate and complies with all necessary regulations.
Our dedicated team pursues any unpaid claims and underpayments and deals with the payer directly to solve the problem and speed up the process.
Our billing specialists post every payment that we receive, reconcile against their remittance advice and detect underpayment using payer contract logic. Your cash flow status is always clear.
We employ the accurate CPT, HCPCS, and ICD-10 coding for procedures in the field of urology. Urological cystoscopies, ureteroscopies, biopsies of the prostate, vasectomy, and urodynamics procedures are all coded with surgical accuracy.
Whenever there is a denial from the insurer, we turn it into an acceptance. Usually, in a single day, we do our research, modify what is necessary, and submit again with all the documents supporting it.
Let’s discuss how our specialized billing services can transform your practice’s financial health.
Outsource urology billing to experts who know your codes, payers, and procedures. See the clear contrast between struggling with in-house billing and succeeding with the help from experts.
📉 Failing to capture 15-20% of the income
📈 Average first-year revenue growth of 22%
Successful urology medical billing and coding depend on the connection between the CPT codes and ICD-10. Here are the approaches to the five most important 2026 codes that Stream RCM takes.
| Procedure | Codes & Application |
|---|---|
| Cystoscopy Coding | With CPT 52000, we use hematuria diagnosis code R31.9 to document the medical necessity of the diagnostic cystoscopy properly for an accurate first-time claim. |
| Stone Removal | In the case of CPT 52351–52356 for ureteroscopy with lithotripsy, we use diagnosis code N20.0 for kidney stones along with codes to document laterality information, which helps in avoiding any denial of the claim. |
| Biopsy Coding | After the 2026 code change for the prostate biopsy code set, we will code CPT 55707–55715 accurately with respect to the imaging guidance and targeting technique used, along with the elevated PSA diagnosis code R97.21. |
| BPH Procedures | For the TURP procedure, we use CPT 52601 together with BPH obstruction diagnosis code N40.1, which documents medical necessity for claims related to surgical intervention. |
| Aquablation Billing | In the new 2026 Aquablation code 52597, we guarantee that bundled imaging guidance is never billed separately to make sure that all the claims associated with BPH remain compliant and free from any issues. |
Coding for new, minimally invasive procedures in prostate care has followed the coding pipeline at fluctuating rates. Aquablation is now a Category I procedure with a reimbursement amount assigned to it, which will ensure consistent reimbursement among commercial and Medicare health plans. However, high-intensity focused ultrasound treatment for benign conditions is still a Category III procedure, which is still considered experimental by some payers. The practices that offer these procedures should employ billers who know the coverage policy. Stream RCM monitors the category of urological procedures so practices know, before scheduling a patient, whether their services will be reimbursed by the health plan.
Our team connects effortlessly with your existing EHR, practice management system, and billing software whether you use Epic, Athena, eClinicalWorks, or any major urology-friendly platform.
Nowadays, payers are paying more attention to the specificity of the diagnoses as well as procedures to approve claims for urologists. A biopsy request that is based on a generalized diagnosis associated with a urinary issue is more likely to be scrutinized than a request based on an elevated PSA level or a particular size and location of a stone. Laterality, severity and cause now play a greater role in the approval process than they did just two years ago. Our Urology Medical Billing Company helps urologists fill in these documentation gaps by analyzing their chart notes and highlighting any unclear diagnoses before the claim creation.
Urology claims fail for predictable reasons. Here is how we prevent each one consistently.
We built our team specifically for urology’s procedural complexity. Every decision, process, and coder we assign is built specifically around urology claims.
Our coders are trained specifically in urology biopsy series, endoscopy bundle codes, and global surgery periods.
The account manager conducts weekly denial review, giving priority to timely urology denial appeals to avoid any deadlines of fourteen days.
Our company monitors real-time changes in CPT and ICD-10-CM codes related to urology throughout the year, implementing them before their effectiveness starting from January.
Our company provides monthly reports on denial trends, aged accounts, and issues specific to each payer.l
Urology spans many CPT codes, modifiers, and overlapping specialties, demanding coding expertise to avoid denials.
Yes, we scale our billing services to fit solo practitioners and large urology groups alike.
Certified coders track CMS and AMA updates, turning them into compliant, audit-ready protocols for claims.
We always verify authorization early and recheck validity against the confirmed procedure date before submission.
The old single biopsy code was replaced with approach-specific codes based on the documented method used.
We review AMA and CMS updates as published, applying changes like 2026’s biopsy overhaul immediately.
Review the full range of urology medical billing and coding services built for stone disease, prostate, and oncology care.
