Urology Coding Alert

Question: I am having trouble coding a transrectal ultrasound performed with a prostate block. The urologist also injected a steroid bilaterally into the prostate for perineal pain. What are the proper CPT codes for these services, and can I bill separately for the steroid (Depo-Medrol)? Georgia Subscriber Answer: You need to report either two or three codes to represent the services you describe, depending on whether your office supplied the steroid for the injection. To code the block procedure with guidance, you should report the following codes:
64450* (Injection, anesthetic agent; other peripheral nerve or branch) for the injection
76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation) for the ultrasonic guidance. You should append modifier -26 (Professional component) to code 76942 if the urologist only performed and documented the supervision and interpretation and did not own the equipment, i.e., if the service was performed in the hospital or other facility setting. And if your office supplied the steroid for the injection, you can report HCPCS supply code J1020, 20 mg.