Wiki Prostate bx and ultrasonic guidance!?

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t_ferg07@yahoo.com

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When my providers do a prostate bx I bill 55700 and 76942. However, apparently 76942 has been deleted. According to information I have found via Medicare it was replaced with +76937.

Occasionaly we bill 76872 which is a transrectal ultrasound. Can someone help me!?! I am NOT comfortable using 76937 and I feel that maybe there's a different code for the guidance for a needle placement?!

Thanks in advance for any help you could provide!
 
Helpful hints

:cool:

Well, after reading your question, I skimmed the CPT book. When performing the prostate bx, the book does guide you to 76942 if guideance is used. It is still a good code that has not been deleted. Yes, Medicare doesn't like to cover that code quite a lot, but it is still a good code.

As far as using 76872, for needle placement, or guidenace, I would not. 76872 is more a diagnostic ultrasound of that genitalia area. I would not be comfortable using that for needle guideance. If you have been, I would think that a 52 modifier would be appropriate.

Anyone else got anything else to add?
 
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