Anesthesia Coding Alert

Question: How should I code anesthesia during transperineal placement of needles or catheters into the prostate for interstitial radioelement application? Mississippi Subscriber Answer: You have several coding options for this procedure, depending on which surgical code the carrier wants.

First, consider 55859 (Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy) as the procedure code. It crosses to anesthesia code 00400 (Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified) with an alternate code of 00902 (Anesthesia for; anorectal procedure). Some carriers require 77776 (Interstitial radiation source application; simple), 77777 (... intermediate) or 77778 (... complex) for the infusion component. These cross to anesthesia code 01922 (Anesthesia for non-invasive imaging or radiation therapy).

If this is a Medicare case, also look at new codes G0261 (Prostate brachytherapy using permanently implanted iodine seeds, including transperineal placement of needles or catheters into the prostate, cystoscopy and application of permanent interstitial radiation source) and G0256 (Prostate brachytherapy using permanently implanted Palladium seeds, including transperitoneal placement of needles or catheters into the prostate, cystoscopy and application of permanent interstitial radiation source). These are temporary codes, but some carriers may accept them. Note that special coverage instructions apply to these G codes (indicated by the blue box shading the code number), so ask your local carrier for correct filing procedures.