Urology Coding Alert

You Be the Coder:

Coding Prostate Biopsies for Medicare Claims

Question: Medicare denied our claim for prostate biopsies; we billed 14 units of 88305 since our in-house pathologist examined 14 specimens. What should we have done differently? Wyoming Subscriber Answer: Current Medicare guidelines state that you should bill HCPCS code G0416 (Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method) for prostate biopsies. You should report this [...]
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