Transrectal Ultrasound guided (TRUS) Biopsy: Overview and Coding

A transrectal ultrasound (TRUS) may also be called prostate sonogram or endorectal ultrasound. It is used to look at the prostate and tissues around it. An ultrasound transducer (also called a probe) sends sound waves through the wall of the rectum and into the prostate and surrounding tissue.

prostate-cancer-or-not-20-728A transrectal ultrasound of the prostate gland is typically used to help diagnose symptoms such as: a nodule felt by a physician during a routine physical exam or prostate cancer screening exam. An elevated blood test result, difficulty urinating.

Prostate ultrasound and biopsy both evaluate the abnormal results of a digital rectal exam or an elevated prostate-specific antigen (PSA) blood test. Prostate ultrasound involves a probe about the size of a finger that is inserted a short distance into the rectum.

A suspicious area to biopsy or may take samples from several places in prostate. Generally, 10 to 12 tissue samples are taken. The entire procedure usually takes about 10 minutes.

Transrectal ultrasonography (TRUS) is a way of creating an image of the prostate gland using sound waves. In conventional ultrasound procedures, a probe placed against the skin sends painless, ultra-high-frequency sound waves into the body.

One of the more useful applications of MRI is in locating cancer that has not shown up on a biopsy. This can be very helpful to a man who has not yet been diagnosed with prostate cancer despite having an elevated PSA and continued biopsies that come back as being “negative,” meaning there is no evidence of cancer.

CPT Codes

55700 – Biopsy, prostate; needle or punch, single or multiple, any approach

76872 – Transrectal ultrasound; this is a diagnostic test for evaluation of the prostate and surrounding structures, looking for abnormalities or suspicious areas worrisome for cancer
76942 –  Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation.

72195-72197: Magnetic resonance (eg, proton) imaging, pelvis (without, with, or without and with contrast)

76376: 3D rendering with interpretation and reporting of computed tomography (CT), MRI, ultrasound, or other tomographic modality with image post-processing under concurrent supervision; not requiring image post-processing on an independent workstation

76377: 3D rendering with interpretation and reporting of CT, MRI, ultrasound, or other tomographic modality with image post-processing under concurrent supervision; requiring image post-processing on an independent workstation

76498: Unlisted magnetic resonance procedure, (eg, diagnostic, interventional)

Remembering Point

pointing handDoctors almost always perform needle biopsies of the prostate (CPT code 55700) under ultrasonic guidance for needle placement (CPT code 76942), and frequently do them in addition to transrectal echography (CPT code 76872). Then all three codes are reported separately.

pointing handUrologists are injecting Xylocaine or some other type of local anesthetic into the prostate. The AMA includes “local infiltration, metacarpal/metatarsal/digital block or topical anaesthesia” as part of the description of the CPT Surgical Package Definition. This type of injection would be considered local infiltration. According to the NCCI, Medicare does not allow separate payment for anesthesia services performed by the physician who also furnishes the medical or surgical service. In this case, payment for the anesthesia service is included in the payment for the medical or surgical procedure.

pointing handThere is some controversy on the billing of the nerve block, 64450 Injection, anesthetic agent; other peripheral nerve or branch with a transurethral ultrasound (TRUS) and ultrasound guided biopsy. If the urologist is performing a nerve block on a Medicare patient, they should not bill the CPT® code 64450 with the TRUS with biopsy.

pointing handFor a transperineal prostate biopsy with mapping instead of a transrectal prostate biopsy use CPT 55706 –Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including image guidance.

Read also











10 thoughts on “Transrectal Ultrasound guided (TRUS) Biopsy: Overview and Coding

  1. I also read bad reviews about the Trimax, which is why I ended up with the wheel locks that I did. I figured if a thief wants to bring two extra 10-ply tires to replace the ones currently on the trailer, there’s not much that won’t stop motivation like that.I’ll definitely be using the Mega Hitch Lock on all trailers I own in the future. That thing is incredibly beefy. Thanks for the comment!


  2. Thank you for all of the effort on this web site. Betty takes pleasure in making time for research and it is easy to understand why. My spouse and i notice all of the dynamic form you give worthwhile techniques via the web site and therefore welcome response from visitors on that content then our own child is undoubtedly learning a great deal. Enjoy the remaining portion of the new year. You’re carrying out a great job.


  3. I’ve been surfing online more than three hours today, yet I never found any interesting article like yours. It is pretty worth enough for me. Personally, if all website owners and bloggers made good content as you did, the net will be much more useful than ever before.


  4. My spouse and I stumbled over here coming from a different web page and thought I may as well check things out. I like what I see so now i am following you. Look forward to looking into your web page for a second time.


  5. It’s really a great and helpful piece of info. I’m happy that you simply shared this helpful information with us. Please stay us informed like this. Thanks for sharing.


  6. I have recently started a blog, the information you offer on this website has helped me greatly. Thanks for all of your time & work. “The more sand that has escaped from the hourglass of our life, the clearer we should see through it.” by Jean Paul.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s