Urology Coding Alert

Question: How should I report the placement of gold seed markers and a TRUS done in the office setting?

New York Subscriber

Answer: First, you should report 55876 (Placement of interstitial device[s] for radiation therapy guidance [e.g., fiducial markers, dosimeter], prostate [via needle, any approach], single or multiple) for the gold seed marker placement. If the urologist also examined the prostate gland transrectally with ultrasound, report 76872 (Ultrasound, transrectal) for the transrectal ultrasound (TRUS).

You should also report 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation) for the ultrasound guidance your urologist used to place the gold seed markers.

Plus: For the actual cost of the markers, also report A4648 (Tissue marker, implantable, any type, each). Some payers will request your patient's invoice before paying for the markers, while others will never pay for this code.

-- Answers to Reader Questions and You Be the Coder contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook.