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Cherie Posted Fri 19th of January, 2018 06:21:32 AM
Are we able to bill 55700 and 52601 together if we have different dx/reasons for doing these together or are they considered part of each other.
SuperCoder Answered Mon 22nd of January, 2018 00:23:13 AM

HELLO

CPT 55700 cannot be reported with 52601 if these both procedures are performed on the same day because a biopsy done as part of an excision is considered standard medical practice. Only if the needle biopsy is performed in an entirely different session and the prostate resection is done as a result of the needle biopsy could these two procedures be reported together. If this were the case, modifier -59 (distinct procedural service) would be appended to the needle biopsy code and there would have to be clear documentation present in the medical record that the biopsy was distinct and separate from the resection.

HOPE THIS HELPS!

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