Urology Coding Alert

Reader Questions:

Probe This Ultrasound Problem

Question: The patient had an elevated prostate-specific antigen (PSA). The urologist performed a transrectal ultrasound, where both transverse and longitudinal scans were completed. The urologist took 12 biopsies from the prostate and several biopsies were taken of the seminal vesicle guided by the transrectal ultrasound probe. How should this be coded?

Wisconsin Subscriber

Answer: You should report the following codes on your claim:

  • 76872 (Ultrasound, transrectal) with modifier 26 (Professional component) appended for the ultrasound
  • 55700 (Biopsy, prostate; needle or punch, single or multiple, any approach) for the prostate biopsy

Note: Since the seminal vesicles are right outside the prostate, include the biopsies of the seminal vesicles as part of the prostate biopsy.