General Surgery Coding Alert

Question: The surgeon performs three ultrasonic biopsies on the right breast and two ultrasonic biopsies on the left breast of a 40-year-old female. The surgeon performed one incision only on each breast. How should this scenario be coded?

South Carolina Subscriber  
Answer: Only two biopsies may be billed, both using 19102 (biopsy of breast; percutaneous, needle core, using imaging guidance). If the surgeon also supervised and interpreted the imaging, 76942 (ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation) may also be billed twice. The number of incisions made (not the number of samples taken for biopsy) determines how many services may be billed. Some carriers may require that the procedure be reported by listing both codes twice; others may want to see a 2 in the units box for the two codes on the CMS claim. If the surgeon or the practice does not own the ultrasound equipment, modifier -26 (professional component) should be appended to 76942.