Urology Coding Alert

You Be the Coder:

Figure Out This Modifier Conundrum

`Question: The patient is in the post-op period from having a transurethral resection of the prostate (TURP) done. The pathology showed prostate cancer. The patient then continued to have SpaceOAR™ and intensity-modulated radiotherapy (IMRT) placement. I billed 55874 and 55876-51. Medicare paid the 55874 but is denying the 55876, stating the procedure code is inconsistent with the modifier used or [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.