# 55700 76942 tc 76872 tc?



## ASC CODER (Mar 12, 2010)

Preoperative diagnosis Elevation of PSA(10.46) 
Postoperative diagnosis Same 
Procedure Ultrasound directed prostate needle biopsy 
Anesthesia Local anesthesia just 0.5% Marcaine plain 20 mL used 
Tissue subjected to pathology Prostate tissue 
EBL 5 mL 
Complications None 

Clinical history: PSA 10.46

Description of operative procedure: 
Patient was laying down a supine position on the operating table. Then, patient was turned on his left side. Patient was placed in a fetal position. Digital rectal examination was performed. Ultrasound probe was placed in the rectum. Ultrasound prostate gland was performed in horizontal and axial plains. 0.5% Marcaine plain was infiltrated transrectally for Pudendal block. Prostate tissues were obtained with biopsy needle and Biopty gun. pieces were obtained from right side and pieces were obtained from the left side. The prostate tissues were subjected to pathological examination. Bleeding was checked. There was no significant bleeding. patient was then returned to the Ambulatory Surgery Area in satisfactory general condition.

Findings: Prostate Volume 36.6 cc
Hyperechoic area in Midzone bilaterally
SE Normal
Capsule appears intact


I was unsure if I bill the 76942

I got
55700
76942 TC
76872 TC

This is a Medicare patient WITHOUT SECONDARY in an ASC. The 76942 has a N1 indicator meaning Medicare is not going to pay for it. But they will pay 76872 so do I report 76942 even though we will get a denial?? 
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