Hi Buster,
Not yet. I don"t believe she will.
Not yet. I don"t believe she will.
Does anyone know if 52649 is the correct and only CPT code needed for HoLEP? Are there any other codes needed for HoLEP?
Just want to make sure my insurance covers HoLEP. Thanks.
From the Internet:
"Mar 31, 2009 · Please explain the difference among CPT codes 52647 (laser to coagulate, 52648 (laser to vaporize), 52649 (laser to enucleate). The physician documentation indicates "the holmium laser was used to ablate the prostate" and "a resectoscope was used to resect the necrotic tissue as well as some of the prostate"."
Just want to make sure my insurance covers HoLEP. Thanks.
From the Internet:
"Mar 31, 2009 · Please explain the difference among CPT codes 52647 (laser to coagulate, 52648 (laser to vaporize), 52649 (laser to enucleate). The physician documentation indicates "the holmium laser was used to ablate the prostate" and "a resectoscope was used to resect the necrotic tissue as well as some of the prostate"."
DL: I looked up my Medicare statements for my Holep at Indiana U hospital back in December 2016.
Among the many entries was this one: "laser fragmentation of prostate tissue with control of bleeding using an endoscope", and it gives the billing code as 52649. Also, you may be interested to know the following numbers for my Holep: total billings including fees of Dr. Lingeman and other doctors, $30,919. Medicare paid or wrote off $26,011. My Virginia Anthem BS/BC secondary insurer paid $882. And I paid zero!
Among the many entries was this one: "laser fragmentation of prostate tissue with control of bleeding using an endoscope", and it gives the billing code as 52649. Also, you may be interested to know the following numbers for my Holep: total billings including fees of Dr. Lingeman and other doctors, $30,919. Medicare paid or wrote off $26,011. My Virginia Anthem BS/BC secondary insurer paid $882. And I paid zero!
Hello Learner,
Thank u for going thru the trouble of looking up ur bill. Ur information is most helpful.
Now we all know the CPT code for HoLEP is 52649 and that it costs $31K if one has to pay out of pocket.
Just wondering did u stay at the hospital overnight after HoLEP? I was told that overnight stay at hospital requires pre approval from the insurance.
Dr. Das normally wants his patients to stay at hospital for 23 hrs after HoLEP. Catheter is 1-6 days.
Thank u again!
Thank u for going thru the trouble of looking up ur bill. Ur information is most helpful.
Now we all know the CPT code for HoLEP is 52649 and that it costs $31K if one has to pay out of pocket.
Just wondering did u stay at the hospital overnight after HoLEP? I was told that overnight stay at hospital requires pre approval from the insurance.
Dr. Das normally wants his patients to stay at hospital for 23 hrs after HoLEP. Catheter is 1-6 days.
Thank u again!
Yes, I stayed overnight, but I didn't ask for pre approval from the insurance company.
I will be seeing Dr. Das next Tuesday to get his consent to do HoLEP on me. The consulting timen is 30min.
I plan to ask Dr. Dasthe following Questions. I would appreciate for ur suggestions.
General questions:
Q1) How long is the HoLEP operating time and morcellation time?
Q2) What are the expected and unexpected complications as well as recovery time?
Q3) When do I need to start the Kegel excercise and for how long?
Q4) What is the followup schedule?
Existing conditions:
Q5) I have severe constipation, will HoLEP make it worse? If yes, how long will it last and how to alleviate it?
Incontinence related questions:
Q6) Among his patients, after HoLEP What is the percentage of having transient incontinence and how long it took to recover?
Is the incontinence due to stress or urge?
Q7) Will HoLEP damage the internal or external sphincters?
Q8) Does he use the two or three lobe enucleation technique and Has he heard of the en-bloc-no-touch technique?
Q9) What is Dr. MIller bladder neck preservation technique, does he uses it?
Retrograde Ejeculation:
10) Among his patients, after HoLEP What is the percentage of having RE? Is there anyway to reduce the chance of getting RE?
I plan to ask Dr. Dasthe following Questions. I would appreciate for ur suggestions.
General questions:
Q1) How long is the HoLEP operating time and morcellation time?
Q2) What are the expected and unexpected complications as well as recovery time?
Q3) When do I need to start the Kegel excercise and for how long?
Q4) What is the followup schedule?
Existing conditions:
Q5) I have severe constipation, will HoLEP make it worse? If yes, how long will it last and how to alleviate it?
Incontinence related questions:
Q6) Among his patients, after HoLEP What is the percentage of having transient incontinence and how long it took to recover?
Is the incontinence due to stress or urge?
Q7) Will HoLEP damage the internal or external sphincters?
Q8) Does he use the two or three lobe enucleation technique and Has he heard of the en-bloc-no-touch technique?
Q9) What is Dr. MIller bladder neck preservation technique, does he uses it?
Retrograde Ejeculation:
10) Among his patients, after HoLEP What is the percentage of having RE? Is there anyway to reduce the chance of getting RE?
Think these are all good Qs DL. I think I can predict what some of his answers will be but I'll just let him reply. I do know he'll be real concerned about the constipation so be sure you tell him. He'll want that avoided at all costs as that will complicate your recovery (pushing will led to bleeding, he will not want any pushing during bowel movements while you're recovering), so I bet he will recommend Miralax and may tell you to start now to get as regular as possible before the surgery. Kegles also ASAP (Darlene his Nurse Practitioner may be able to help you there, she will likely interview you prior to your meeting with him so be sure to tell her all these things also). I for one will be anxious t hear how things go. Good luck!
Thanks and I sincerely appreciate ur advice!
I too want to hear the answers directly from him.
I too want to hear the answers directly from him.
This is for readers who are planning to have HoLEP.
For insurance, the doctor's office will initiate preauthorization pap work before HoLEP. But mistakes can happen. To reduce the chance of making mistakes, one could make phone calls himself.
For me, I called the doctor's surgical coordinator, the hospital admission and the anathesialogy department to make sure that each accepts my insurance.
I also called my insurance to make sure that it covers CPT code 52649, code for HoLEP.
My previous urologist's surgical coordinator had scheduled me Urolift. She submitted an "preauthorization" to the insurance. But on the day of the surgery, she had not heard back from insurance. She wanted me to go for the surgery saying that the approval from insurance would come later. I disagreed and asked her to rescheduled. At the end BCBS rejected the preauthorization. If I had gone for the Urolift, I would have to pay $30,000 out of my own pocket.
When I called the insurance to check if it covered Urolift, the representative made a mistake and told me it was covered but in reality there were a set of medical necessity conditions which must be met before it agrees to pay for Urolift. I did not meet some of the conditions.
So now, I am careful, take the matter into my own hands, double check if the surgery is covered by my insurance.
For insurance, the doctor's office will initiate preauthorization pap work before HoLEP. But mistakes can happen. To reduce the chance of making mistakes, one could make phone calls himself.
For me, I called the doctor's surgical coordinator, the hospital admission and the anathesialogy department to make sure that each accepts my insurance.
I also called my insurance to make sure that it covers CPT code 52649, code for HoLEP.
My previous urologist's surgical coordinator had scheduled me Urolift. She submitted an "preauthorization" to the insurance. But on the day of the surgery, she had not heard back from insurance. She wanted me to go for the surgery saying that the approval from insurance would come later. I disagreed and asked her to rescheduled. At the end BCBS rejected the preauthorization. If I had gone for the Urolift, I would have to pay $30,000 out of my own pocket.
When I called the insurance to check if it covered Urolift, the representative made a mistake and told me it was covered but in reality there were a set of medical necessity conditions which must be met before it agrees to pay for Urolift. I did not meet some of the conditions.
So now, I am careful, take the matter into my own hands, double check if the surgery is covered by my insurance.
You're welcome DL. BTW, Dr Das will probably be real curious as to how you found him and why you decided to go to him. I know he asked me a lot about that (especially since I had come from DC to see him). I know you're coming from a distance as well so I assume he'll have the same curiosity as to why you came to him. Just wanted you to be aware of this possibility.
Thank u for the heads up and also thank u for suggesting Dr. Das for HoLEP. My other choice is Dr. Chris DeBlasio from Long Island. For me, driving to Long Island is a big hassle because of the unpredictable traffic and amount of tolls whereas driving to phili is all interstate highways, but need to pay for parking at Jefferson.
Question about pads.
Does anyone has information that if I have to buy and bring some pads to be used right after HoLEP? If yes, what brand, how many and where to buy?
Thanks.
Does anyone has information that if I have to buy and bring some pads to be used right after HoLEP? If yes, what brand, how many and where to buy?
Thanks.
I wish I had brought depends briefs. I ended up adding a guard inside the brief. Before I did that I wet my pants 3 times on my first day home.
Hi Buster,
Thanks for the information. Is "Depends" the brand name,? is "briefs" the pads ? What is "guard"? Where can I buy these items?
Thanks.
Thanks for the information. Is "Depends" the brand name,? is "briefs" the pads ? What is "guard"? Where can I buy these items?
Thanks.
Depends is a brand name. I have found the brand in drug stores in Northern NY in the incontinence aisle. Depends has two styles of briefs. The decision has to be based on your build. Pads come in various strengths. The pads that are more absorbent are called guards. The very light pad is called a shield.
There is another brand, Tena. Those are harder to find and more expensive. There are also store brands that are available.
I do strongly advise you take your own briefs and possibly pads. Do you have someone to drive you home?
There is another brand, Tena. Those are harder to find and more expensive. There are also store brands that are available.
I do strongly advise you take your own briefs and possibly pads. Do you have someone to drive you home?