March 28, 2025

Scott, Mark, and Dr. Ray Painter discuss questions that came into the PRS Helpdesk.

NGS sent a newsletter about the use of: cpt code G0463 as a primary code for G2211. Need more info if possible.
Do nurse practitioners get paid at 100% for procedures like a PNE when signing notes in NM by themselves?
a) Medicare NGS is denying CPT 52332 for bilateral stents with denial CO-151. This seems to be a constant problem with denials for frequency and/or bilateral stents.
Has the policy been changed; I have not been able to find any changes regarding stents insertion or exchanges.
Thanks
b)Hi,
Wondering if you can help me with this Medicare patients.
NGS is denying the claim on several patients stating that this code has a frequency limit on 52332.
NGS has a problem with both frequency and bilateral stents
I have searched everywhere and find no information on this code for frequency limits per year or bilateral stents.
Appreciate any help on this code.

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UCR 236: NGS Updates on G0463 & G2211, APP Billing for Neuromodulation, and Bilateral Ureteral Stent [52332] Denials