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Urology Coding Alert

Reader Question:

Capture TURP and TRUS Pay With Modifier 59

Published on Wed Sep 12, 2012

Question: The urologist performed a TRUS and prostatic biopsy because of an elevated PSA, and a TURP for LUTS secondary to prostatic enlargement, bladder neck obstruction, and chronic urinary retention. Can we bill for a TURP and a TRUS with biopsy in the same setting?Texas SubscriberAnswer: Yes, you can bill for both procedures. For this surgical encounter, you should report the following codes if your urologist performed all of these procedures in the hospital: 52601(Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included]). Attach diagnosis code 600.01 (Hypertrophy [benign] of prostate with urinary obstruction and other lower urinary tract symptoms, [LUTS]).55700 (Biopsy, prostate; needle or punch, single or multiple, any approach). Append modifier 59 (Distinct procedural service) to break the bundle between 52601 and 55700. Attach diagnosis code 790.93 (Elevated prostate specific antigen, [PSA]). Append modifier [...]
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