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Urology Coding Alert

Reader Questions:

Code Specifically for Saturation Biopsy

Published on Wed Jan 26, 2005

Question: My urologist wants me to code a saturation biopsy of the prostate with Cryogrid 24 cores with a genitourinary unlisted-procedure code. Is this right, or is there a more specific code I should use?

Florida Subscriber Answer: There is no specific CPT code for a saturation biopsy of the prostate gland, but you don't need to resort to an unlisted-procedure code. Report 55700-22 (Biopsy, prostate; needle or punch, single or multiple, any approach; unusual procedural services). You should append modifier -22 to indicate the extra work that was involved and documented.
 
Most important: Along with this claim, you must send the operative report and a short explanatory cover letter explaining the nature and reason for the extra work and the extra number of biopsies performed. However, the extra reimbursement - if any - will probably be minimal.
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