Ask Dr. Z

A skin block was performed. A peri-prostatic block was performed by placing a spinal needle on each side towards the prostate base and injecting 10ml of 1% xylocaine for a total of 20ml. Under ultrasound guidance 3 gold markers were inserted into the prostate (right apex, mid-gland, and left mid-gland) placed at the appropriate depth and avoiding the urethra. A long spinal needle was then used to hydro-dissect the perirectal space with sterile normal saline. Separation was confirmed in both the transverse and sagittal planes. The needle was aspirated slightly to ensure the needle was not intravascular. While keeping the needle in place, the hydrogel applicator was attached. The hydrogel was then injected over 5 seconds. The placement of the hydrogel was evaluated and the ultrasound probe was removed. After 15 minutes of observation the patient was released. Would you code 55874 with 55876 and 76942 or is the ultrasound guidance included in 55876 because you used 55874?