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Gold seed marker placement

Julie Posted Sun 04th of August, 2013 23:33:29 PM

What is the first-listed diagnosis for gold seed marker placement for future Cyberknife surgery? The malignancy code or a V code? (If it is a V code, please specify which one).

SuperCoder Answered Thu 08th of August, 2013 06:59:38 AM

Placement of gold seed markers is coded as 55876 (Placement of interstitial device[s] for radiation therapy guidance [e.g., fiducial markers, dosimeter], prostate [via needle, any approach], single or multiple). Also codes that can be billed based on services provided are:

76942 Ultrasonic guidance for needle placement, and
76872 Transrectal UTS [if Urologist has done]

As cost to supply of tissue marker, bill A4648 "Tissue marker, implantable, any type, each" if payer allows.

Now, diagnosis code code would depend on the current diagnostic condition when the seed markers are being implanted. If malignancy is existing, code malignancy code [primary / secondary - based on documentation of the cancer]. If malignancy is no longer existing and it's a past condition (personal history) go with V codes. Usually gold seeds are implanted in case of current/existing cancer treatment, so more chance of coding a malignancy code. [However as a coder you would need to depend on the available documentation from the physician]

A few possible Dx codes could be [just an indicative list]:

185 - Malignant neoplasm of prostate
198.82 - Secondary malignant neoplasm of genital organs
233.4 - Carcinoma in situ of prostate
236.5 - Neoplasm of uncertain behavior of prostate
239.5 - Neoplasm of unspecified nature of other genitourinary organs

SuperCoder Answered Thu 08th of August, 2013 07:32:49 AM

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