Revenue Cycle Insider

Question: If my urologist performs a fiducial marker placement in the office, how should this be coded?

Revenue Cycle Insider Subscriber

Answer: To code fiducial marker placement when performed in the office, you will begin by reporting 55876 (Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple) for the placement of the marker.

After this, you will report any radiological guidance your urologist used while placing the markers. Most likely, you’ll likely report 76942 (Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation) for ultrasonic guidance.

In some cases, your urologist may need to perform a transrectal ultrasound (TRUS) to determine the prostate volume and the correct placement of the markers. If this is the case, also report 76872 (Ultrasound, transrectal).

Supply coding: If your urologist is performing this procedure in office often, your facility is most likely paying for markers. If this is the case, you should also report A4648 (Tissue marker, implantable, any type, each) to recoup the cost of the markers or “seeds.” Since the descriptor specifies that these are coded individually, you should submit A4648 for each seed your urologist places. For example, if your provider places four markers, report A4648 x 4. The payer may require you to submit a separate invoice for the markers.

Lindsey Bush, BA, MA, CPC, Production Editor, AAPC