Prostate Biopsies Slammed Again in Medicare Proposed Fees for 2018

The CAP is engaged with the insurance carrier UnitedHealthcare regarding its new billing policy that severely affects processing of claims for immunohistochemistry (IHC) services.

Palmetto Medicare, the Part B Medicare Administrative Contractor for the states of North Carolina, South Carolina, Virginia and West Virginia, has issued a directive on proper CPT coding for Prostate Needle Biopsy cases containing more than 9 individual biopsy samples regardless of the Surgical method utilized to obtain the samples. 

CMS CR7631-Clarified Place of Service (POS) Coding Instructions effective April 1, 2013 are available on CMS website. Updated POS for pathology services and independent laboratories will be provided via another CR