Magnetic Resonance Imaging-informed Prostate Biopsies and Coding Guideline

Image result for magnetic resonance imaging (mri)-guided prostate biopsy

Magnetic resonance imaging (MRI)-guided prostate biopsy is more accurate and specific in  compare to traditional two-dimensional (2D) transrectal ultrasound (TRUS)-guided biopsy or perineal biopsy.

Magnetic resonance imaging (MRI)-guided prostate biopsy has three technique:-

  1. Direct MRI-guided biopsy (in-bore)
  2. Cognitive registration
  3. MRITRUS fusion Biopsy

Direct MRI-guided biopsy

The procedure is performed in the MRI gantry itself.

Cognitive registration

Multi parametric MRI with three-dimensional (3D) processing images, and mentally determines the location of lesions concerning for cancer, and subsequently targets these areas during TRUS biopsy.

MRITRUS Fusion Biopsy

The previously obtained MRI images are fused to real-time TRUS images to theoretically allow more specific and precise biopsies; this procedure uses proprietary equipment and can be performed under local or general anesthesia.

CPT codes use for these types of procedures are following:

  • 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)

pointing handImportant Facts

  • When the multiparametric MRI is performed, the MRI itself and the 3D rendering are typically performed by and billed by the radiologist, and therefore should not be billed by the urologist.
  • For MRI-TRUS fusion biopsy, there are no specific CPT codes that describe procedure. In addition, this procedure is considered investigational. The increased costs, the current applicable codes for the urologist are the same three codes used for standard 2D TRUS-guided biopsy (CPT codes 76872, 76942, and 55700). 
  • The Urologist can’t bill CPT code 77021 (Magnetic resonance guidance for needle placement [eg, for biopsy, needle aspiration, injection, or placement of localization device], radiologic supervision and interpretation), as this would be the correct code to bill if the patient had been on the MRI gantry.
  • Code 76498 (Unlisted magnetic resonance procedure [eg, diagnostic, interventional]) for the additional work of fusing the MRI and the ultrasound, but it is unlikely to be reimbursed.
  • A 3D image from the TRUS is being performed and images captured, can be use code (76376 or 76377), but it may be necessary to check with insurance providers to check their coverage policy. Physicians’ offices may choose to have their patients sign an Advanced Beneficiary Notice for procedures that are typically not covered.

13 responses to “Magnetic Resonance Imaging-informed Prostate Biopsies and Coding Guideline”

  1. […] Magnetic resonance imaging (MRI)-guided prostate biopsy; coding guideline […]

  2. Thanks for your marvelous posting! I definitely enjoyed reading it, you happen to be a great author.I will ensure that I bookmark your blog and will often come back at some point. I want to encourage you to definitely continue your great writing, have a nice holiday weekend!

  3. Very good post. I certainly appreciate this website. Keep writing!
    cartier anelli con diamanti imitazione http://www.bestcalove.ru/it/best-replica-cartier-love-ring-yellow-gold-set-six-diamonds-b4032400-p776/

  4. I’ve read several just right stuff here. Certainly price bookmarking for revisiting.I surprise how so much effort you set to create the sort ofexcellent informative website.

  5. very good publish, i certainly love this website, keep on it

  6. I’m truly enjoying the design and layout of your blog. It’s a very easy on the eyes which makes it much more pleasant for me to come here and visit more often. Did you hire out a developer to create your theme? Exceptional work!

  7. This is a great post. Thank you for sharing.

  8. This is a great post. Thank you for sharing.

  9. This is a great post. Thank you for sharing.

  10. With thanks! Valuable information!

  11. I am always browsing online for posts that can aid me. Thx!

  12. Hi there! I just would like to offer you a huge thumbs up for your excellent info you’ve got right here on this post. I will be returning to your blog for more soon.

  13. I could not resist commenting. Very well written!

Leave a Reply to Transrectal Ultrasound guided (TRUS) Biopsy: Overview and Coding – Rishu Shukla Cancel reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: