Urology Coding Alert
Cystoscopy With Biopsy
Illinois Subscriber
Answer: If the needle biopsy of the prostate and seminal vesicles is performed via a noncystoscopic approach, report 55700 (biopsy, prostate; needle or punch, single or multiple, any approach). If a cystoscopy is performed as a separate procedure in addition to the needle or punch biopsy, then 52000 (cystourethroscopy [separate procedure]) can be reported with modifier -59 (distinct procedural service). In addition, if ultrasonic guidance is used to guide the needle biopsy of the prostate, 76942 (ultrasonic guidance for needle biopsy, radiological supervision and interpretation) can also be reported. If the needle biopsy is a transurethral biopsy of the prostate, an unlisted procedure code (55899) would be reported for the cystoscopy with transurethral needle biopsy of the prostate. According to the CPT, a biopsy via endoscopy is always coded with a single code, therefore a cystoscopy code would not be reported additionally in this case.
Urology Coding Alert
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Medicare Fee Schedule
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