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Thread: 55700 - biopsy, prostate; needle or punch, single or multiple, any approach

  1. #1
    Join Date
    Apr 2007
    Harrisburg, PA

    Question 55700 - biopsy, prostate; needle or punch, single or multiple, any approach

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    Standard 12 core transrectal biopsy - Would this be billed with 55700 with 12 in the services field?
    Deb Stoll

  2. #2
    Join Date
    Apr 2007
    Portland, Oregon

    Default 55700

    It depends, when a urologist and radiologist perform the procedure together:
    - The urologist reports code 55700.
    - The radiologist reports coe 76942.
    Also, please check the record with code 76872: transrectal echography. It should be bill with the written report document the finding and signed by the physician. Based on the Medicare coverage.
    The mention is taking 10-12 tissue cores has become the standard of care (Wilson &Crawford,2004). Sextant & extended biopsy with 10-12 cores is generally performed with local anesthesia.
    Otherwise, the saturation biopsy involves taking between 20 to 40 cores biopsies. This will be use code 0137T: biopsy, prostate needle saturation sampling for prostate mapping.

    I hope it will help.

    Good luck

  3. #3
    Join Date
    Apr 2007
    Woodbridge, VA


    By definition, CPT 52400 includes multiple biopsies. Would the urologist need to indicate the number of biopsies in the claim itself? We typically bill the following set of codes: 55700, 76872, 76942, 64450-59 based on our documentation.

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