Urology Coding Alert

Anthem Blue Cross and Blue Shield in Connecticut on July 15 joined five of its fellow plans  California, Nebraska, New Jersey, North Carolina and Pennsylvania  in developing a coverage policy for cryosurgical ablation for prostate cancer, CPT 55873 (Cryosurgical ablation of the prostate [includes ultrasonic guidance for interstitial cryosurgical probe placement]).

The six BCBS plans that adopted 55873 coverage policies have become members of an elite club of major private insurers opting to cover cryosurgical ablation of the prostate including United Healthcare, AETNA/USHS, Pacificare/Secure Horizons and Humana. Thanks to these new coverage policies, more than 75 million Americans now have access to paid cryosurgery, according to Endocare Inc., a developer of tools for cancer and other disease diagnosis and treatment.

"Thousands of men [under 65] diagnosed with prostate cancer are not covered under Medicare, making private insurance coverage especially important as younger and lower-risk patients are selecting cryosurgery as their preferred treatment," says Paul Mikus, chairman and chief executive officer of Endocare Inc. "We believe these decisions will result in better healthcare and better cost management for these payers."