CPT^® 55876, Under Other Procedures on the Prostate

The Current Procedural Terminology (CPT^®) code 55876 as maintained by American Medical Association, is a medical procedural code under the range - Other Procedures on the Prostate.

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Summary

In this procedure, the provider places one or more location markers or a device that measures radiation dosage within tissue gaps in the prostate prior to the administration of radiation treatment, or radiotherapy. He inserts the items into the prostate via a needle.

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Help with modifier

We sent the claim back in with a 78 on 55876. They are still denying us saying that the procedure code is inconsistent with the modifier used or a required modifier is missing. Any other suggestions?... [ Read More ]

Help with modifier

Medicare doesn't really like modifier 51. I would have just used modifier 78 on both 55874 and 55876. That could be why they are denying.... [ Read More ]

Help with modifier

Patient is in the post op period from having a TURP done. The pathology showed prostate cancer. The patient then continued to have Space OAR and IMRT placement. I billed 55874.78 and 55876.78/51. Medi... [ Read More ]

Should you code for the SpaceOAR supply???

[QUOTE="sls, post: 492343, member: 20617"] Thank you for your response!! This is what I have been trying to tell the business office, but wasn't as clear as you. You summed it up nicely, going to stea... [ Read More ]

Nexplanon removal w/Fluoroscopic guidance

77002 Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure) ... [ Read More ]

Fiducial markers Placement and Rectal hydrogel spacers insertion.

Asssistance for coding for Fiducial markers Placement and Rectal hydrogel spacers insertion. Will there be 2 CPT: Fiducial markers Placement 55876 & Rectal hydrogel spacers insertion.55874. Thank... [ Read More ]

flouroscopic guidance denial

I believe you would also bill 77002 with 64420 and 64421 X3 . It is included within the "64400-64448" code set in the below note . (Use [URL='https://coder.aapc.com/cpt-codes/77002'][U]77002[/U][/... [ Read More ]

flouroscopic guidance denial

64420 is for a single level;[B] Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level[/B] and 64421 is and add on code to 64420; [B]Injection(s), anesthetic agent(s) and/o... [ Read More ]

Gold seeds after prostatectomy

I'm hoping someone might have some insight on this. We have urologists that are planning to place gold seed markers after the patient has had a prostatectomy. Normally we would bill 55876, but since t... [ Read More ]

63047 and 77002

There is an NCCI edit between 63047 and 77002. A modifier is allowed to bypass the edit, but when there is an edit, I typically go to the NCCI Policy Manual chapter that talks about the code I'm apply... [ Read More ]

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