Health Information Management

Do not report G codes for prostate brachytherapy procedures

APCs Insider, April 8, 2005

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

Do not report G codes for prostate brachytherapy procedures

QUESTION: Recently we discovered that we were not being paid for our prostate brachytherapy procedures since we were using the all-inclusive G codes. Can you tell us how we are to bill them?

ANSWER: In the last few years, CMS has shifted its policy on how to bill for prostate brachytherapy procedures and seed placement. The all-inclusive G codes were used for calendar year 2003, but they are no longer active.

Prior to 2003 and beginning again in 2004 to present day, you must report 55859 (Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy) for the surgical portion. For application of the actual seeds, use the code series 77776-77784 (interstitial radioelement application). Bill one of the following C codes to report the type of seeds used: C1716-C1720.

Remember to use the units field to denote how many seeds were used, for example, if 65 palladium 103 seeds were placed then report HCPCS code C1720 with the units as 65.

Additionally, you may report code 76965 if ultrasound guidance is used during the procedure.



Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular