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CPT 55706 - Billing with Prostate Biopsy

Robert J Posted Fri 29th of August, 2014 13:47:51 PM

When CPT 55706 is billed with CPT 55700, CPT 76842 and CPT 76942 on the same date of service, Is there any limitation on the maximum number of units which can be billed and are payable for CPT 55706 ? Do the major insurance carriers have limitations on the max number of units that they typically will cover and pay for CPT 55706?

SuperCoder Answered Tue 02nd of September, 2014 01:30:27 AM

You may not bill 55706 and 55700 on the same date of service. Code 55706, saturation biopsies are inclusive of single and multiple biopsies represented by 55700.

Yes, there is a limitation to maximum number of unit you may bill in a day. Typically, most insurance carriers covers only one unit per day for this code. Even when the provider performs multiple biopsies in one session, you may bill this code only once.

Thanks !!

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