Urology Coding Alert

Question: Can you bill CPT 52601 and 55700 Kansas Subscriber Answer: CPT code 55700 (biopsy, prostate; needle or punch, single or multiple, any approach) cannot be reported with 52601 (transurethral electrosurgical resection of prostate, including control of postoperative bleeding, compete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included]) if the 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.