Wiki Transperineal Biopsy using a Perineologic Device

KaylaRieken

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Our physicians started doing transperineal prostate biopsies using a Perineologic device. I sent a couple operative reports into the AUA when we started doing them in 2019 and they suggested CPT code 55706. What are your thoughts?

Lubricated ultrasound probe was introduced per rectum. Prostate was visualized and measured in the transverse and sagittal planes, found to be around 50 g measured. There was a suggestion of mild middle lobe enlargement protruding into the bladder. The known lesions in the anterior transition zones were somewhat difficult to assess on ultrasound. There was suggestion of a hypoechoic lesion in the right anterior aspect of the transition zone but less distinct on the left side. A block was performed of the perineum with 2% lidocaine and needle trocar of the Perineolic device was introduced on the left aspect of the perineum. We them performed systematic biopsies on the left with 4 cores taken from the posterior aspect of the prostate, 4 cores from the left base, and 4 cores from the left anterior aspect of the prostate, paying close attention to sample thoroughly the anterior transition zone. The needle trocar was introduced in the right side where systematic biopsies were performed with 4 cores taken from the left anterior aspect of the prostate and 3 cores from the left base. Several of the cores incorporated the lesion seen on the ultrasound, and then 4 core3s were taken from the right posterior aspect of the prostate.
 
I believe this would still be provided in CPT code 55700, "...any approach." 55706 is a saturation biopsy done in a hospital under general or spinal anesthesia.
Michael A. Ferragamo MD, FACS
 
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