Urology Coding Alert

 Question: What are our best CPT^® options when we’re coding for a prostate biopsy in the office?

Florida Subscriber

Answer: Many urology practices have three code options they rely on for in-office prostate biopsies, depending on the exact situation:

• 55700 – Biopsy, prostate; needle or punch, single or multiple, any approach
• 76872 – Ultrasound, transrectal
• 76942 – Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation with modifier 59 (Distinct procedural service).

Take note: As of Jan. 1, 2017, CPT^® and CMS have indicated that when you’re billing for a transrectal biopsy of the prostate gland, should report either 76872 or 76942 – but not both. Select the code according to which sonogram is documented in the operative report.