# Ultrasound FNA with image guideance (thyroid only)



## steinj96 (Mar 3, 2016)

Department is charging 10022 with 2 units and Premera is denying would I use the bilateral modifier or modifier 59 in this case. 

Thank you for your help 


ULTRASOUND-GUIDED THYROID BIOPSY, RIGHT LOBE:
ULTRASOUND-GUIDED THYROID BIOPSY, LEFT LOBE:
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HISTORY: Bilateral small thyroid nodules with appearance of micro calcifications, superior pole left lobe and mid zone right lobe; requested fine-needle aspiration biopsies.
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TECHNIQUE: Informed consent obtained. Each of the two nodules, mid zone right lobe, and superior pole left lobe had 5 needle passes with 25-gauge needle with real time ultrasound guidance, as per thyroid nodule biopsy protocol. Skin over right lobe and left lobe prepped and draped in a sterile fashion with 1% Xylocaine used for local anesthetic. Biopsy passes were performed under real-time ultrasound guidance. Pathologist on hand to evaluate initial aspirate. Final pathology report pending. Patient tolerated procedure well, and there were no apparent complications.
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IMPRESSION: *
Real-time ultrasound-guided fine-needle aspiration biopsy of single right lobe and single left lobe thyroid nodules, as described


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## chembree (Mar 15, 2016)

The FNA does not have a bilateral indicator, so it would need to be billed with a 59 or an equivalent 'X' modifier.


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