Urology Coding Alert

Question: Can I report fiducial marker placement that my urologist performs in the office? If so, what is the proper coding?

Kansas Subscriber

Answer: Yes, you can report this procedure when your urologist performs fiducial marker placement in the office. Start by reporting 55876 (Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple) for the tissue marker placement.

Next, you will report the radiological guidance your urologist used to help them place the markers. Depending on the type of guidance your urologist used, you’ll likely report 76942 (Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation) for other ultrasonic guidance. Your urologist

may perform a transrectal ultrasound (TRUS) to determine the prostate volume and where the markers should be placed. If they do, you should also report 76872 (Ultrasound, transrectal).

Supply coding: Assuming your office is paying for markers because your urologist is performing this procedure in the office, you should also report A4648 (Tissue marker, implantable, any type, each) to recoup the cost of the seeds. Since the descriptor specifies “each,” you should submit A4648 for each seed your urologist places. For example, if your provider places five markers, report A4648 x 5. The payer may require you submit an invoice for the markers.