Why Iridium Suite for urology

Urology billing software for a practice that is clinic, procedure room and operating room at once

A urology practice bills office visits, in-office procedures, injections, imaging and surgery, often for the same patient in the same month. Whether those claims are paid depends on modifiers, global surgical periods and the place of service. Iridium Suite was developed in a clinical setting to handle that mix, with the checks built into charge entry rather than left to the clearinghouse.

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Iridium Suite delivers

Visits and procedures

Claim scrubber with CCI edits and payer rules on every line, as charges are entered
Pop-up warnings when an office visit and a procedure on the same day need modifier 25, or cannot be billed together
Bundling and code-conflict edits for procedures performed in the same session
Facility Track: global, professional or technical component chosen from where the service was performed
Configurable rules for in-office drug units and the JW and JZ wastage modifiers

Scheduling and follow-up

Built-in scheduler for physicians, physician assistants, rooms and equipment, with color-coded appointment types
Recalls by target month for surveillance cystoscopies, PSA checks and injection cycles, with follow-up calls logged per patient
Check-out in one screen: future appointments, patient payments, recalls and charge capture
Prior authorization tracking by patient with permitted CPT codes and a visit count-down
Real-time eligibility with demographics and policy data filled from the payer response

Payments and reporting

Automatic ERA posting; most payments adjudicated without staff intervention
Primary, secondary and tertiary claims generated automatically in payer order
Accounts receivable work screens with payer follow-up notes kept on the account
Reimbursement Analyzer and Biller Productivity reports
Scanned operative notes, ABNs and insurance cards attached to the patient record

Where urology billing goes wrong, and what the software does about it

A visit and a procedure on the same day. An established patient visit with a cystoscopy is the everyday case. The visit is paid only when it is significant and separately identifiable, and only with modifier 25; without it the payer bundles the visit into the procedure and the line is denied with claim adjustment reason code 97. Iridium Suite’s scrubber warns at charge entry when an evaluation and management code and a procedure share a date, so the biller confirms the modifier belongs there before the claim goes out.

Global surgical periods. Office cystoscopy and prostate biopsy carry no post-operative period, while procedures such as a transurethral resection or a vasectomy carry a 90-day global period in which routine follow-up visits are not billable. Visits inside the period that are unrelated (modifier 24), staged (modifier 58) or a return to the operating room (modifier 78) are the exceptions. The scrubber’s bundling edits flag a routine visit billed inside a global period, and the notes on the account record why an exception applies.

The place of service determines the component. In-office imaging and urodynamics have professional and technical components. Performed in the practice’s own office, the practice bills the global code; performed at the hospital, the physician bills the professional component with modifier 26 and the hospital bills the technical side. Iridium Suite’s Facility Track chooses the component from the location on the schedule, so the decision is made once per site rather than once per claim. The global, professional and technical charges article explains the rule in full.

Drugs given in the office. Hormone therapy injections and intravesical treatments are billed by HCPCS unit, with the administration code on its own line and wastage from single-dose vials reported with modifier JW, or JZ when nothing was discarded. Configurable scrubber rules check the unit count and the wastage modifier for each drug you stock.

Surveillance and recalls. Bladder cancer surveillance, PSA monitoring and injection cycles are recurring work that pays only if the patient comes back. Recalls are set at check-out, searched by target month, and each follow-up call is logged against the patient, so nothing depends on a paper tickler file.

Authorizations and eligibility. Imaging, surgery and many drugs need prior authorization; Iridium Suite tracks each one by patient with the permitted codes and a count-down of visits, and real-time eligibility confirms the policy before the appointment.

Urology billing guides

Written for billers by the people who build the software, kept current with the rules, and free.

Frequently asked

Does Iridium Suite warn when a visit and a procedure are on the same day?

Yes. The scrubber warns at charge entry when an evaluation and management code and a procedure share a date, so the biller confirms whether modifier 25 belongs on the visit before the claim goes out.

Does it handle global surgical periods?

The bundling edits flag a routine visit billed inside a procedure's global period. When an exception applies, such as modifier 24, 58 or 78, the reason is kept in the notes on the account.

How are imaging and urodynamics billed when done at the hospital?

Facility Track picks the global, professional or technical component from the location on the schedule. In the practice's own office the global code is billed; at the hospital the physician bills the professional component with modifier 26.

Can it track surveillance cystoscopies and PSA follow-ups?

Yes. Recalls are set at check-out with a target month, staff search them by month, and each follow-up call is logged on the patient.