Urology Coding Alert

Question: I noticed new HCPCS codes for brachytherapy seed implants, G0256 and G0261. Should I use these instead of 55859 when my urologist implants seeds for a Medicare patient?

Montana Subscriber

Answer: The answer is no. The new HCPCS codes effective April 1, 2003 for brachytherapy seed implants have thrown coders a curve ball, but don't let these HCPCS additions throw you off, because these codes don't affect how you code brachytherapy seeds implanted by a urologist.

HCPCS codes 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) and 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) apply only to billings by hospitals or ambulatory surgical centers.

To report brachytherapy seed implantation by a urologist, you should continue to report CPT codes 55859 (Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy) and 76965 (Ultrasound guidance for interstitial radioelement application). Append modifier -26 (Professional component) to code 76965 to indicate to the payer that the urologist did not own the sonographic guidance equipment.