Coding Interstitial Brachytherapy of prostate

This is done by injecting the radioactive application into the prostate with needles or catheter transperineally. The physician may also confirm the position of seeds by cystoscopy. So coding brachytherapy of prostate involves three sets of codes as follows:



1. 55875 Transperineal placement of needles or catheters into prostate with or without cystoscopy

2. 77776-77787 Interstitial radioelement application.

3. 76965  Ultrasonic guidance for interstitial radioelement application.



Fluoroscopic guidance may also be performed in addition to ultrasonic guidance and it should be reported separately with 77002. Ultrasound volume study of the prostate (76873) if performed should not be reported as it is bundled into 77776-77787 codes. C codes needs to be reported if you are coding for a facility.

 

EXAMPLE:

ADMITTING DIAGNOSIS: Prostate cancer.

DISCHARGE DIAGNOSIS: Prostate cancer.

PROCEDURE PERFORMED:  Interstitial Brachytherapy of prostate.

PROCEDURE DETAILS: 



The patient is taken to the operating room and prepared for the procedure. A 21-189 needles were used to instill 47 1-125 seeds into the prostate . Postoperative cystoscopy performed, which confirmed adequate positions of seeds.



DX  CODE   DESCRIPTION  

1    185         Malignant Neoplasm Prostate



PX  CODE   DESCRIPTION  

1    92.27     Implantation/Insertion Of Radioactive Element 

2    57.32    Cystoscopy NEC



CPT CODE   DESCRIPTION                

1    55875    Transperineal Needle/Cath Placemnt into Prostate w/wo Cystoscopy 

2    77778    Interstitial Radioelement Application; Complex   

3    C1728   Brachytherapy  Seed Adm  

4    C1715    Brachytherapy Needles