May 22, 2026

In this episode, Scott, Mark, and Dr. Ray Painter revisit ureteral stent removal and replacement coding after listener feedback highlighted the need for additional clarification on when cystoscopic codes versus fluoroscopic exchange codes apply. The discussion then shifts to emerging RAC audits targeting prostate artery embolization (PAE) claims involving CPT codes 37242 and 37243, emphasizing the importance of detailed documentation and medical necessity support. The episode wraps with a deep dive into Medicare’s medically unlikely edit (MUE) for add-on code 55715 for additional prostate biopsy lesions—exploring why the edit conflicts with CPT guidance, how practices should report multiple lesions, and why appeals may be necessary to receive proper reimbursement.

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