General Surgery Coding Alert

Question: When I’m trying to find an FNA procedure code in the CPT^® manual, I find it very confusing. The codes are in numerical order, but it seems like most of them have a red note that states, “code is out of numerical sequence,” and are listed again with a # symbol in front of them. Could you please explain this?

Virginia Subscriber

Answer: Until 2019, CPT^® provided just two codes for fine needle aspiration (FNA) extraction, the now-revised code 10021 (Fine needle aspiration biopsy, without imaging guidance; first lesion) and the now-deleted code 10022 (Fine needle aspiration; with imaging guidance).

With the update, CPT^® created nine new FNA codes that detail the type of imaging guidance used, and whether any specimen taken is an initial or additional lesion.

CPT^® used to assign new numbers to existing codes when a adding a new series of codes, but that’s not the case anymore. Instead, CPT^® now keeps existing code numbers and adds new codes around it in logical groupings based on the type of procedure, even if that means the codes are out of numerical sequence.

This whole process is called resequencing, and it occurs throughout the CPT^® manual. But you are correct to observe that the phenomenon dominates the FNA section.