Wiki MRI FUSION FOR PROSTATE BIOPSY in OFFICE question CPT billing-2 questions

[tera828@yahoo.com]

We perform MRI FUSION prostate biopsies in Office setting with a Radiologist that comes in 1x month bringing/using the MRI image disk and Fusion Program that we rent to use and pay him per patient. There is a question of the billing for this by our office.
1.We have been billing 55700, 76872-59, 76942-59, 76377-59 and 77021-59. We are not billing with 26 modifiers as we are renting the equipment and Radiology equipment being used for MRI Needle placement for Prostate Biopsy. We are not performing the MRI but using the MRI Images on disk for needle placement. Can we get confirmation of correct coding/billing or information needed to bill correctly?

2. The Radiologist has told us we can bill 64430 Pain block for Anal Pain ICD-10 K62.89 &/or K94.29 for these such MRI FUSION Biopsies. Does anyone have information on this subject?

 

[astephens]

mri fusion

check code 76498

 

[smckee]

We perform MRI FUSION prostate biopsies in Office setting with a Radiologist that comes in 1x month bringing/using the MRI image disk and Fusion Program that we rent to use and pay him per patient. There is a question of the billing for this by our office.
1.We have been billing 55700, 76872-59, 76942-59, 76377-59 and 77021-59. We are not billing with 26 modifiers as we are renting the equipment and Radiology equipment being used for MRI Needle placement for Prostate Biopsy. We are not performing the MRI but using the MRI Images on disk for needle placement. Can we get confirmation of correct coding/billing or information needed to bill correctly?

2. The Radiologist has told us we can bill 64430 Pain block for Anal Pain ICD-10 K62.89 &/or K94.29 for these such MRI FUSION Biopsies. Does anyone have information on this subject?

I'm interested in knowing if you have any further information on this topic. Our providers also perform this procedure and we are having discussions about which ultrasound code is most appropriate... 76872 or 76942. The providers are concerned that because the transrectal ultrasound isn't being used for a diagnostic purpose, rather a guidance purpose, that 76872 isn't appropriate. I've talked with other large health systems and they are using 55700 w/76872. Unfortunately, I haven't found any CMS guidance one way or another. I'd appreciate any resources or additional knowledge you may have to share since you posted this originally. Thank you. Staci

 

[elizabeth0916@yahoo.com]

You can use HCPCS for Medicine code and yes you can charges for anesthesia drugs along with procedures codes, make sure the BX report have name of the drugs for audit purposes.