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Pathology/Lab Coding Alert

You Be the Coder:

Pocket the Prostate Biopsy Difference

Published on Fri Jan 15, 2021

Question: Why is there such a huge reimbursement difference for prostate biopsy for Medicare versus non-Medicare patients? Louisiana Subscriber Answer: When you bill Medicare for prostate biopsy, you must report a single unit of G0416 (Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method), no matter how many needle specimens the case involves. For non-Medicare payers, you’ll [...]
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