# Second Posting - Prostate Biopsy U/S



## Partha (Oct 8, 2009)

*This has been discussed in the forum & backed by CPT Assistant when the transrectal US is a proper diagnostic one and distinctly different from the US guidance for prostate biopsy we can code 76872 in addition to 55700 & 76942, but what we are seeing is most payers deny 76872 as bundled? 

Any inputs will be greatly appreciated! *


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## Lisa Bledsoe (Oct 8, 2009)

Many payors may need modifier -59 on 76872 to bypass their edits, if appropriate.


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## Partha (Oct 8, 2009)

Thanks - but will it be ok to use mod 59 when there is no CCI edit?


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## Lisa Bledsoe (Oct 8, 2009)

I looked at the claim edits for a couple of the payors and they will accept -59.  Keep in mind that commercial carriers don't alwasy follow CCI edits.


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## Partha (Oct 19, 2009)

*Commercials...*

...Agreed commercials have different edits and don't necessarily follow Medicare's CCI edits but how will we check/apply on our claims what commercials follow...?


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