ED Coding and Reimbursement Alert

Question: Encounter notes indicate that the ED physician performed a puncture aspiration of a bulla. During the aspiration, the physician employed guidance for the needle placement. Can I code separately for the guidance?

Iowa Subscriber

Answer: Yes, you should report the guidance separately — you just have to figure out which guidance code best suits your situation.

Do this: Report 10160 (Puncture aspiration of abscess, hematoma, bulla, or cyst) for the puncture aspiration. Then, go back and check the notes for more information on the type of guidance the physician employed. Then, choose one of the following codes to accompany 10060 on your claim:

• 76942 (Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation)
• +77002 (Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure)) Note: This is a restricted add on code for which CPT^® specifically lists only a few dozen eligible codes with which it can be paired. That list includes 10160.
• 77012 (Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation)
• 77021 (Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation).