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Nerve block for Prostate Biopsy

Paula Posted Thu 27th of December, 2012 21:13:18 PM

Hello,
We are coding/billing for hospital based radiologist.
The patient is having a prostate biospy done by the Urologist.
The radiologist IS present for the entire procedure.
He does a diagnostic prostate US, also provides US guidance and the radiologist injects the left and the right neural vascular bundle.
The urologist performs the actual percutanous biopsy.
Can the radiolgist bill, 76942-26, 76872-26, and 64450 for the block?
The urologist is billing 55700 for the biopsy.
Thank you,
Paula/hmg0138

Paula Posted Thu 03rd of January, 2013 21:54:51 PM

biopsy,prostate,neural

SuperCoder Answered Fri 04th of January, 2013 18:05:25 PM

Hi,

We are working on this and will get back soon.

Thanks.

SuperCoder Answered Fri 04th of January, 2013 20:11:30 PM

Codes 76942-26 and 76872-26 will likely be appropriate. If a single physician had performed both the biopsy (55700) and block (64450) then payers who follow CCI edits wouldn’t reimburse 64450 separately. But because here the radiologist performed the block and the urologist performed the biopsy, the radiologist should be able to report the block. Also look at whether the payer considers 64450 a unilateral code and whether you may report it bilaterally.

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