Urology Coding Alert

Question: Can I charge for a surgical tray (HCPCS A4550) to private payers when administering Lupron, mitomycin and other drugs?

Florida Subscriber

Answer: Some private payers will pay a tray charge when administering Lupron, mitomycin, BCG, etc. Some private payers will also pay for a tray for vasectomies and prostate biopsies. Use A4550 only for Medicare. Some HMOs have their own special code for a tray charge, so check with the payer first.

You cannot bill Medicare a tray charge for administering injections. However, the Medicare list of procedures for which a tray may be charged using A4550 includes 52005-52260, 52270-52277, 52282-52283 and 52290-52315.

Medicare will discontinue code A4550 in 2002 as the practice expense portion of the Medicare fee becomes final. The increased payment for many procedures to be seen in 2002 will result from a primary tray charge payment.